Lo C Y, van Heerden J A, Soreide J A, Grant C S, Thompson G B, Lloyd R V, Harmsen W S
Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Br J Surg. 1996 Apr;83(4):528-31. doi: 10.1002/bjs.1800830432.
A policy of supportive treatment is frequently adopted for patients with metastatic disease to the adrenal glands. This study reports an experience with adrenalectomy for adrenal metastasis. Between 1983 and 1993, adrenalectomy was performed in 52 patients for metastasis to the adrenal glands. Survival was calculated by the Kaplan-Meier method and compared with the log rank test. Primary tumour sites included kidney (n = 15), lung (n = 11), colon (n = 7), unknown (n = 5), stomach (n = 3), melanoma (n = 3) and other (n = 8). Adenocarcinoma (69 per cent) was the most common histological cell type. Thirty-two patients were asymptomatic on initial evaluation. Symptomatic adrenal pain relief was achieved in 11 of 13 patients. Overall survival rates were 73 per cent at 1 year and 40 per cent at 2 years. Patients with potentially curative resection had better survival than those who had a palliative procedure. Patients with adrenal metastases due to adenocarcinoma had improved survival compared with that in those with other histological cell types. Although long-term survival is generally poor, highly selected patients with adrenal metastasis (symptomatic disease or adenocarcinoma) may benefit from surgical resection.
对于肾上腺转移瘤患者，常采用支持性治疗策略。本研究报告了肾上腺切除术治疗肾上腺转移瘤的经验。1983年至1993年间，52例患者因肾上腺转移接受了肾上腺切除术。采用Kaplan-Meier法计算生存率，并通过对数秩检验进行比较。原发肿瘤部位包括肾脏（n = 15）、肺（n = 11）、结肠（n = 7）、不明（n = 5）、胃（n = 3）、黑色素瘤（n = 3）和其他（n = 8）。腺癌（69%）是最常见的组织学细胞类型。32例患者初评时无症状。13例有症状的患者中，11例肾上腺疼痛缓解。1年总生存率为73%，2年为40%。有可能根治性切除的患者比接受姑息性手术的患者生存率更高。与其他组织学细胞类型的患者相比，腺癌导致肾上腺转移的患者生存率有所提高。虽然总体长期生存率通常较差，但经过严格挑选的肾上腺转移瘤患者（有症状的疾病或腺癌）可能从手术切除中获益。
