Adrenal metastasis from renal cell carcinoma: Significance of adrenalectomy
Adrenal metastasis from renal cell carcinoma: Significance of adrenalectomy
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DOI：
10.1046/j.1442-2042.2002.00442.x
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发表时间：
2002-03-01
影响因子：
2.6
通讯作者：
Orikasa, S
中科院分区：
文献类型：
--
作者：
Ito, A;Satoh, M;Orikasa, S
背景资料：本研究探讨了肾细胞癌（RCC）引起的肾上腺转移，目的是评估在根治性肾切除术中是否需要常规行同侧肾上腺切除术。方法：对东北大学医学院1977年至1996年行根治性肾切除术的256例RCC患者的同侧和对侧肾上腺转移进行了研究。结果：256例患者中有12例（4.7%）有肾上腺转移。这12例患者中有10例进展为播散性疾病，预后极差。两名患有孤立性肾上腺转移的患者在21年和7年内保持无病状态。4例患者显示转移到对侧肾上腺。肾上腺转移瘤的12例中有7例被确定为术前或术后的计算机断层扫描（CT），并在另外5个宏观在surgery.Conclusions：肾上腺切除术被认为是一种可能的根治性治疗孤立性肾上腺转移瘤的患者。然而，这种转移的发生率很低，在RCC病例中可能发生对侧肾上腺转移。因此，我们认为，肾上腺切除术应只在放射学证据显示转移瘤在肾上腺或如果严重的疾病是目前在肾切除术。
Background: The present study examined adrenal metastasis resulting from renal cell carcinoma (RCC), with the aim of assessing the need for routine ipsilateral adrenalectomy during radical nephrectomy.Methods: Ipsilateral and contralateral adrenal metastases were investigated in 256 patients with RCC who had undergone radical nephrectomy from 1977 to 1996 at the Tohoku University School of Medicine.Results: Twelve of the 256 patients (4.7%) had adrenal metastasis. Ten of these 12 patients had progressed to disseminated disease with very poor prognosis. Two patients who had solitary adrenal metastases remained disease-free for 21 and 7 years. Four patients showed metastases to the contralateral adrenal gland. Adrenal metastases in seven of 12 patients were identified by pre- or postoperative computed tomography (CT), and in another five macroscopically during surgery.Conclusions: Adrenalectomy was regarded as a possible curative treatment for patients with solitary adrenal metastasis. However, the incidence of this kind of metastasis was minimal and contralateral adrenal metastases may occur in RCC cases. We therefore believe that adrenalectomy should only be performed if radiographic evidence reveals metastases in the adrenal gland or if gross disease is present at the time of nephrectomy.