Cedermark B J, Blumenson L E, Pickren J W, Holyoke D E, Elias E G
Surg Gynecol Obstet. 1977 Apr;144(4):537-46.
A study to determine the frequency of metastases to the adrenal glands following carcinoma of the colon and rectum was undertaken. Patients with, or without, adrenal spread were compared regarding age, sex, race and survival time. The over-all metastatic pattern was analyzed to determine its usefulness for predicting the presence of metastases to the adrenal glands. Autopsy reports and clinical records of patients with adrenal spread were reviewed regarding the extent of tumor involvement in the glands and possible adrenal insufficiency. Of 457 patients with adenocarcinoma of the colon and rectum who underwent autopsy, 63 or 14% had metastasis to the adrenal glands. Of these, 29 had bilateral involvement. Patients with bilateral metastases had a lower median age than did those without adrenal spread. No correlation was found between adrenal metastatic status and sex or race. Although survival time was found to be shorter for patients with bilateral metastases of the adrenal glands, adrenal insufficiency did not seem to be the reason for this shorter survival time. In retrospect, however, the presence of adrenal insufficiency could not be ruled out in several of these patients. Eight sites were studied with regard to whether or not metastatic involvement in a specific site might indicate a higher risk for simultaneous metastases to the adrenal glands. It was found for all sites that, when involved, there was a higher frequency of metastases to the adrenals than if free of tumor. Metastases especially above the diaphragm indicated a considerable risk for adrenal involvement. Different sites were combined in groups and studied in the same way. It was found that the more sites involved, the higher the relative chance of metastases to the adrenals. It was suggested that the results presented may be useful in predicting the relative chance of adrenal metastases in patients with advanced carcinoma of the colon and rectum.
开展了一项研究，以确定结肠直肠癌发生肾上腺转移的频率。对有或无肾上腺转移的患者在年龄、性别、种族和生存时间方面进行了比较。分析了总体转移模式，以确定其对预测肾上腺转移存在的有用性。查阅了肾上腺转移患者的尸检报告和临床记录，以了解肿瘤累及肾上腺的程度以及可能存在的肾上腺功能不全情况。在接受尸检的457例结肠直肠癌患者中，63例（14%）发生了肾上腺转移。其中，29例为双侧受累。双侧转移患者的年龄中位数低于无肾上腺转移者。未发现肾上腺转移状态与性别或种族之间存在相关性。虽然发现肾上腺双侧转移患者的生存时间较短，但肾上腺功能不全似乎并非生存时间较短的原因。然而，回顾来看，这些患者中有几例无法排除肾上腺功能不全的存在。研究了八个部位，以确定特定部位的转移累及是否可能提示同时发生肾上腺转移的风险更高。结果发现，对于所有部位，当发生转移时，肾上腺转移的频率高于无肿瘤累及的情况。尤其是膈肌以上的转移提示肾上腺受累的风险相当高。将不同部位分组并以同样方式进行研究。结果发现，受累部位越多，肾上腺转移的相对可能性就越高。研究表明，所呈现的结果可能有助于预测晚期结肠直肠癌患者肾上腺转移的相对可能性。
