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Feasibility of laparoscopic adrenalectomy for metastatic adrenal tumors in selected patients: a retrospective multicenter study of Japanese populations.
Goto, Takayuki; Inoue, Takahiro; Kobayashi, Takashi; Yamasaki, Toshinari; Ishitoya, Satoshi; Segawa, Takehiko; Ito, Noriyuki; Shichiri, Yasumasa; Okumura, Kazuhiro; Okuno, Hiroshi; Kawakita, Mutsushi; Kanaoka, Toshio; Terada, Naoki; Mukai, Shoichiro; Sugi, Motohiko; Kinoshita, Hidefumi; Kamoto, Toshiyuki; Matsuda, Tadashi; Ogawa, Osamu.
Afiliación
  • Goto T; Department of Urology, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawahara-Cho, Sakyo-Ku, Kyoto, 606-8507, Japan.
  • Inoue T; Department of Urology, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawahara-Cho, Sakyo-Ku, Kyoto, 606-8507, Japan.
  • Kobayashi T; Department of Urology, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawahara-Cho, Sakyo-Ku, Kyoto, 606-8507, Japan.
  • Yamasaki T; Department of Urology, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawahara-Cho, Sakyo-Ku, Kyoto, 606-8507, Japan.
  • Ishitoya S; Department of Urology, Japanese Red Cross Otsu Hospital, Otsu, Shiga, Japan.
  • Segawa T; Department of Urology, Kyoto City Hospital, Kyoto, Japan.
  • Ito N; Department of Urology, Kobe City Nishi-Kobe Medical Center, Kobe, Hyogo, Japan.
  • Shichiri Y; Department of Urology, Otsu City Hospital, Otsu, Shiga, Japan.
  • Okumura K; Department of Urology, Tenri Hospital, Nara, Japan.
  • Okuno H; Department of Urology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.
  • Kawakita M; Department of Urology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan.
  • Kanaoka T; Department of Urology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan.
  • Terada N; Department of Urology, University of Miyazaki Hospital, Miyazaki, Japan.
  • Mukai S; Department of Urology, University of Miyazaki Hospital, Miyazaki, Japan.
  • Sugi M; Department of Urology, Kansai Medical University Hospital, Osaka, Japan.
  • Kinoshita H; Department of Urology, Kansai Medical University Hospital, Osaka, Japan.
  • Kamoto T; Department of Urology, University of Miyazaki Hospital, Miyazaki, Japan.
  • Matsuda T; Department of Urology, Kansai Medical University Hospital, Osaka, Japan.
  • Ogawa O; Department of Urology, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawahara-Cho, Sakyo-Ku, Kyoto, 606-8507, Japan. ogawao@kuhp.kyoto-u.ac.jp.
Int J Clin Oncol ; 25(1): 126-134, 2020 Jan.
Article en En | MEDLINE | ID: mdl-31471786
BACKGROUND: Because of the small numbers of cases in single centers, the indications for and survival benefits of adrenalectomy for adrenal metastasis remain unclear. We evaluated the outcomes of laparoscopic adrenalectomy for patients with adrenal metastasis. METHODS: We retrospectively analyzed the records of 67 patients who underwent laparoscopic adrenalectomy for metastatic disease from 2003 to 2017 at 11 hospitals. Associations of clinical, surgical, and pathologic features with overall survival (OS) and positive surgical margins were evaluated using univariate and multivariate Cox regression analyses and univariate logistic regression analysis. RESULTS: Lung cancer (30%) and renal cell carcinoma (30%) were the most common primary tumor types. Intraoperative complications were observed in seven patients (10%) and postoperative complications in seven (10%). The surgical margin was positive in 10 patients (15%). The median OS was 3.8 years. Univariate analysis showed that the tumor size, episodes of extra-adrenal metastasis before adrenalectomy, extra-adrenal metastasis at the time of adrenalectomy, and positive surgical margins were significantly associated with shorter OS (p = 0.022, p = 0.005, p < 0.001, and p = 0.022, respectively). Multivariate analysis showed that extra-adrenal metastasis at the time of adrenalectomy and positive surgical margins remained statistically significant (p = 0.022 and p = 0.049, respectively). In the univariate analysis, the tumor size was significantly associated with positive surgical margins (p = 0.039). CONCLUSIONS: Laparoscopic adrenalectomy for adrenal metastasis can be safely performed in selected patients, and patients with isolated adrenal metastasis and negative surgical margins seem to have more favorable outcomes.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Laparoscopía / Neoplasias de las Glándulas Suprarrenales / Adrenalectomía Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: Int J Clin Oncol Asunto de la revista: NEOPLASIAS Año: 2020 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Japón
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Laparoscopía / Neoplasias de las Glándulas Suprarrenales / Adrenalectomía Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: Int J Clin Oncol Asunto de la revista: NEOPLASIAS Año: 2020 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Japón