MP03-15 LAPAROSCOPIC ADRENALECTOMY FOR METASTATIC TUMORS IS FEASIBLE FOR SELECTED PATIENTS: RETROSPECTIVE MULTICENTER STUDY IN JAPANESE POPULATIONS

Abstract

You have accessJournal of UrologyAdrenal1 Apr 2018MP03-15 LAPAROSCOPIC ADRENALECTOMY FOR METASTATIC TUMORS IS FEASIBLE FOR SELECTED PATIENTS: RETROSPECTIVE MULTICENTER STUDY IN JAPANESE POPULATIONS Takayuki Goto, Takahiro Inoue, Takashi Kobayashi, Toshinari Yamasaki, Satoshi Ishitoya, Takehiko Segawa, Noriyuki Ito, Yasumasa Shichiri, Kazuhiro Okumura, Hiroshi Okuno, Mutsushi Kawakita, Toshio Kanaoka, Naoki Terada, Shoichiro Mukai, Motohiko Sugi, Hidefumi Kinoshita, Toshiyuki Kamoto, Tadashi Matsuda, and Osamu Ogawa Takayuki GotoTakayuki Goto More articles by this author , Takahiro InoueTakahiro Inoue More articles by this author , Takashi KobayashiTakashi Kobayashi More articles by this author , Toshinari YamasakiToshinari Yamasaki More articles by this author , Satoshi IshitoyaSatoshi Ishitoya More articles by this author , Takehiko SegawaTakehiko Segawa More articles by this author , Noriyuki ItoNoriyuki Ito More articles by this author , Yasumasa ShichiriYasumasa Shichiri More articles by this author , Kazuhiro OkumuraKazuhiro Okumura More articles by this author , Hiroshi OkunoHiroshi Okuno More articles by this author , Mutsushi KawakitaMutsushi Kawakita More articles by this author , Toshio KanaokaToshio Kanaoka More articles by this author , Naoki TeradaNaoki Terada More articles by this author , Shoichiro MukaiShoichiro Mukai More articles by this author , Motohiko SugiMotohiko Sugi More articles by this author , Hidefumi KinoshitaHidefumi Kinoshita More articles by this author , Toshiyuki KamotoToshiyuki Kamoto More articles by this author , Tadashi MatsudaTadashi Matsuda More articles by this author , and Osamu OgawaOsamu Ogawa More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.3058AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The adrenal grands are common sites of metastasis for various malignancies. Recent published guidelines indicate that surgical resection may be considered in those patients with an isolated adrenal metastasis. However, indications and survival benefits of adrenalectomy (ADX) for adrenal metastasis are not clearly established. We evaluated outcomes of laparoscopic ADX for patients with adrenal metastasis. METHODS We retrospectively analyzed the records of 67 patients who underwent laparoscopic ADX from 2003 to 2017 for metastatic disease at 3 academic hospitals and 8 teaching hospitals in Japan. Associations of clinical, surgical, and pathologic features with overall survival (OS) were evaluated using univariate and multivariate Cox regression analysis. RESULTS Lung cancer (20, 30%) and renal cell carcinoma (20, 30%) were the most common primary tumor types followed by liver (10, 15%) and colorectal cancer (6, 9%). A total of 27 (40%) patients had the episodes of extra-adrenal metastasis before ADX; 48 (72%) patients had isolated adrenal metastasis and 19 (28%) patients had extra-adrenal metastasis at ADX. Retroperitoneal approach was selected in 18 (27%) patients and open conversion was performed in 5 (7%) patients. Intraoperative capsule rupture was observed in 11 (16%) patients and surgical margin was positive in 10 (15%) patients. The median OS was 3.8years (95%CI 2.4-11.9). The survival rate at 1, 2, 3, and 5 years were 82%, 69%, 58%, and 43%, respectively. On univariate analysis, tumor size, absence of extra-adrenal metastasis before ADX, isolated adrenal metastasis at ADX, and negative surgical margin were significantly associated with longer OS (HR 1.28, p = 0.022; HR 0.30, p = 0.005; HR 0.17, p < 0.001; HR 0.31, p = 0.022, respectively). On multivariate analysis, isolated adrenal metastasis at ADX and negative surgical margin remained statistically significant (HR 0.24, p = 0.022; HR 0.34, p = 0.049, respectively). CONCLUSIONS Results of the present retrospective, multicenter study indicate that selected patients with metastatic adrenal disease can benefit from laparoscopic ADX for adrenal metastases in terms of survival. Of those undergoing laparoscopic ADX, patients with isolated adrenal metastasis and negative surgical margin seem to have more favorable outcomes. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e28-e29 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Takayuki Goto More articles by this author Takahiro Inoue More articles by this author Takashi Kobayashi More articles by this author Toshinari Yamasaki More articles by this author Satoshi Ishitoya More articles by this author Takehiko Segawa More articles by this author Noriyuki Ito More articles by this author Yasumasa Shichiri More articles by this author Kazuhiro Okumura More articles by this author Hiroshi Okuno More articles by this author Mutsushi Kawakita More articles by this author Toshio Kanaoka More articles by this author Naoki Terada More articles by this author Shoichiro Mukai More articles by this author Motohiko Sugi More articles by this author Hidefumi Kinoshita More articles by this author Toshiyuki Kamoto More articles by this author Tadashi Matsuda More articles by this author Osamu Ogawa More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...