A COMPARISON OF ADRENALECTOMY WITH OTHER RESECTIONS FOR METASTATIC CANCERS

BACKGROUND: Although adrenal metastases were once considered incurable , recent anecdotal reports recommend adrenalectomy for isolated metast ases. METHODS: Computerized files of all US Department of Veterans Aff airs (DVA) hospital admissions and deaths from 1988 to 1994 identified patients undergoing isolated adrenal resections, and hospitalization records were obtained. Patients without a death record were assumed to be alive. RESULTS: In 47 patients with adrenalectomy for metastases, only 5 patients did not die within 3 years: 2 each had metachronous ve nal or colorectal metastases, and 1 had a pulmonary primary. Thirteen patients with other primary sites all expired within 3 years. Operativ e mortality was 4% in these 47 patients and also in 706 other adrenale ctomies without metastases. CONCLUSIONS: Adrenalectomy for metastatic carcinoma in the DVA was safe, with a projected 5-year survival rate ( 13%) that is significantly inferior (P less than or equal to 0.05) to resections for colorectal metastases to lung (36%) or liver (26%), but superior to brain (none). (C) 1998 by Excerpta Medica, Inc.