Surgical treatment of solitary adrenal metastasis from non-small cell lung cancer

Background. Adrenal glands are the site of solitary synchronous and metachronous metastases in non-small cell lung cancer (NSCLC). The presence of solitary adrenal metastasis from lung cancer provides survival benefit; however, currently, there are no exact treatment algorithms. Objectives of the study: to assess short-and long-term treatment outcomes in patients with adrenal metastases from NSCLC. Material and Methods. Treatment outcomes of patients undergoing adrenalectomy for NSCLC were analyzed. Results. From 1993 to 2014, 13 patients (11 males/2 females aged between 44 and 78, median age 58 years) with solitary adrenal metastases (adenocarcinoma (n=7), squamous cell carcinoma (n=4), large cell carcinoma (n=2); synchronous metastases - 5 cases (38.5%) and metachronous metastases - 8 cases (61.5 %), underwent adrenalectomy (one patient was given stereotactic radiation therapy for brain metastasis). Laparoscopic adrenalectomy was performed in 10 (76.9 %) cases, open adrenalectomy was performed in 3 (23.1 %) cases. The average adrenal tumor diameter was 74.6 ± 13.3 mm (25-170 mm). In the early postoperative period, two lethal outcomes were recorded. The median follow-up time after adrenalectomy was 20 months (3 to 267 months), the average follow-up time was 51.5 ± 23.5 months. The 3-year overall survival rates in patients with synchronous and metachronous metastases were 25.0 ± 2.2 % and 57.1 ± 1.9 %, respectively; however, the differences were not statistically significant (p=0.63; LogRank). The extent of surgery, morphological tumor type and status of regional lymph nodes produced no influence on the survival rate (p>0.05). Conclusion. No factors influencing survival in patients with solitary adrenal metastases from NSCLC were identified.