SP2.2.1 Surgical Resection of metastases to the adrenal gland

Abstract

Abstract Aims The adrenal gland is a common metastatic site for lung, breast, skin, renal, thyroid, and colorectal cancers. Our aim was to review resection of adrenal metastases and their primary pathology and the impact of adrenalectomy on the survival and disease free survival rate. Methods Retrospective review of adrenalectomy for adrenal metastases in a single regional centre between June 2010–2020. Results 34 adrenalectomies in 33 patients were performed. Median age of patients was 70 (39–82). All adrenal lesions were diagnosed on staging or surveillance CT scan. Isolated adrenal metastases were seen in 26 patients. The most common primary malignancy was renal cell carcinoma (RCC) (n=20), followed by non small cell lung cancer (NSCLC) (n=6), colorectal adenocarcinoma (n=2) and infiltrating ductal breast carcinoma (n=2). Other primaries include malignant melanoma, oesophageal adenocarcinoma, prostate adenocarcinoma and hepatocellular carcinoma (each n=1). Adrenalectomy was carried out for diagnosis in 5 cases, 4 where no resection of the primary lesion was performed. Median time from resection of primary lesion was 4 years (1–16). 5 patients had synchronous adrenal metastases, 1 with synchronous resection of primary. At the time of writing, there was a 38% mortality. 84% of deaths were due to disease progression. Median survival from adrenalectomy was 23 months (4–52 months). Of the surviving patients 76% are disease free and under oncological or clinical surveillance. 24% underwent further systemic or localised oncological therapy. Conclusions Survival rate following adrenalectomy for metastatic deposits is 62%. Better outcomes are observed in patients with RCC metastases.