Adrenalectomy for isolated adrenal metastases from non-adrenal cancer

Adrenalectomy for metastatic cancer is rarely performed. The survival benef it for patients undergoing resection of isolated adrenal metastases is not clear. The goal of this study was to compile a series of such cases from na tional and international sources and examine patient survival. The patient series was derived from published series and case reports, plus eight new c ases from an international registry of patients. We found 77 patients. We e xamined the effect of primary tumor site, metastasis size, and disease-free interval on postoperative survival duration, including only cases where co mplete resection with negative margins was achieved. We compared these pati ents with a large series from Memorial Sloan-Kettering Cancer Center (N=37) . The median survival time after adrenalectomy was 23 months, with an opera tive mortality rate of 3.9%. There was a significant difference in survival duration depending on primary tumor site. A longer disease-free interval f rom time of primary cancer therapy to adrenal metastasis was associated wit h a longer postoperative survival after adrenalectomy. Metastasis size did not affect survival. Survival times for USA and non-USA patients were simil ar. Survival duration of the 77 analytical patients was similar to that of the 37 non-analytical patients from Memorial Sloan-Kettering Cancer Center. Selected patients, particularly those with long disease-free intervals and favorable tumor biology, should be offered resection for isolated adrenal metastases.