Metman Madelon J H, Viëtor Charlotte L, Seinen Auke J, Berends Annika M A, Hemmer Patrick H J, Kerstens Michiel N, Feelders Richard A, Franssen Gaston J H, van Ginhoven Tessa M, Kruijff Schelto
Department of Surgical Oncology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.
Department of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC Cancer Institute, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands.
Cancers (Basel). 2021 Dec 29;14(1):156. doi: 10.3390/cancers14010156.
The adrenal glands are common dissemination sites for metastasis of various solid tumors. Surgical treatment is often recommended because targeted therapies and immunotherapy are frequently ineffective for adrenal metastasis. We report the experience with short-term and long-term surgical outcomes of patients undergoing surgery for adrenal metastasis in two hospitals. A retrospective, multicenter study was performed to analyze patient characteristics, tumor-related data, perioperative outcomes, and oncological outcomes. Postoperative complications that occurred within 30 days were scored according to the Clavien Dindo classification. Metastatic adrenalectomy was performed in 95 patients. We observed an increase from an average of 3 metastatic adrenalectomies per year between 2001-2005 to 10 between 2015-2019. The most frequent underlying malignancies were colorectal and lung cancer. In 55.8%, minimal invasive adrenalectomy was performed, including six conversions to open surgery. A total of 37.9% of patients had postoperative complications, of which ileus or gastroparesis, wound problems, pneumonia, and heart arrhythmias were the most occurring complications. Improved cancer care has led to an increased demand for metastatic adrenalectomy over the past years. Complication rates of 37.9% are significant and cannot be neglected. Therefore, multidisciplinary teams should weigh the decision to perform metastatic adrenalectomy for each patient individually, taking into account the drawbacks of the described morbidity versus the potential benefits.
肾上腺是各种实体瘤转移的常见播散部位。由于靶向治疗和免疫治疗对肾上腺转移瘤往往无效，因此通常建议进行手术治疗。我们报告了两家医院接受肾上腺转移瘤手术患者的短期和长期手术结果。进行了一项回顾性多中心研究，以分析患者特征、肿瘤相关数据、围手术期结果和肿瘤学结果。根据Clavien Dindo分类对30天内发生的术后并发症进行评分。95例患者接受了转移性肾上腺切除术。我们观察到，2001年至2005年期间每年平均进行3例转移性肾上腺切除术，到2015年至2019年期间增加到10例。最常见的潜在恶性肿瘤是结直肠癌和肺癌。55.8%的患者接受了微创肾上腺切除术，其中6例转为开放手术。共有37.9%的患者出现术后并发症，其中肠梗阻或胃轻瘫、伤口问题、肺炎和心律失常是最常见的并发症。在过去几年中，癌症治疗的改善导致对转移性肾上腺切除术的需求增加。37.9%的并发症发生率很高，不容忽视。因此，多学科团队应根据所述发病率的缺点与潜在益处，为每位患者单独权衡进行转移性肾上腺切除术的决定。
