Prognostic factors for recurrence-free and overall survival after adrenalectomy for metastatic carcinoma: a retrospective cohort pilot study

BMC Urology

Research Article

Jun Eul Hwang¹  Suk Hee Heo²  Dong Deuk Kwon³  Eu Chang Hwang³  Seung Il Jung³  Taek Won Kang³  Insang Hwang³  Seok Ho Kang⁴  Je Jong Kim⁴  Sung Gu Kang⁴  Jun Cheon⁴  Jeong Gu Lee⁴ 

[1] Department of Hemato-oncology, Chonnam National University Medical School, Gwangju, South Korea;Department of Radiology, Chonnam National University Medical School, Gwangju, South Korea;Department of Urology, Chonnam National University Medical School, Gwangju, South Korea;Department of Urology, Korea University School of Medicine, 73, Inchon-ro, Seongbuk-gu, Seoul, Republic of Korea;

关键词: Adrenalectomy;    Neoplasm metastasis;    Prognosis;    Survival;   

DOI  :  10.1186/1471-2490-14-41

 received in 2014-01-28, accepted in 2014-05-14,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundThe survival benefits of adrenalectomy (ADx) in the setting of metastatic cancer and prognostic factors for recurrence-free (RFS) and overall survival (OS) after adrenalectomy for metastatic carcinoma are still under debate. We evaluated the impact of clinicopathological variables on RFS and OS after ADx for metastatic carcinoma in patients with primary cancer.MethodsA total of 32 patients undergoing ADx for metastatic cancer between 2004 and 2012 at two tertiary medical centers. Metastases were regarded as synchronous (<6 months) or metachronous (≥6 months) depending on the interval after primary surgery. Associations of perioperative clinicopathologic variables with RFS and OS were analyzed using Cox regression models.ResultsIn total, 32 patients received ADx for metastatic primary tumors located in the lung (n = 11), colon (n = 4), liver (n = 5), stomach (n = 3), kidney (n = 4), pancreas (n = 2), glottis, esophagus, cervix, and ovary (n = 1 each). The overall recurrence rate after adrenalectomy was 62.5% (n = 20). By univariate analysis, C-reactive protein, inflammation-based prognosis score, and adrenalectomy for curative intent were associated with RFS and OS. Independent prognostic factors for shorter RFS were operative method (laparoscopy HR 4.68, 95% CI 1.61-13.61, p = 0.005) and inflammation-based prognostic score (HR 11.8, 95% CI 2.50-55.7, p = 0.002). For shorter OS, synchronous metastasis (HR 3.05, 95% CI 1.07-11.94, p = 0.048) and inflammation-based prognostic score (HR 6.65, 95% CI 1.25-35.23, p = 0.026) were identified as independent prognostic factors.ConclusionsOur pilot study suggests that synchronous disease and inflammation-based prognostic score are significant prognostic factors for survival and should be considered when performing ADx for metastatic diseases.

【 授权许可】

Unknown   
© Hwang et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.