ADRENAL ADENOCARCINOMA - A REVIEW OF 53 CASES

Problem: Fifty-three patients (30 men, 23 women) with histologically proven adrenal carcinoma were reviewed. Nineteen (36%) had endocrine manifestations from functioning tumors. Arteriography was positive in 95% (19/20), CT scan in 94% (17/18), and ultrasound in 92% (12/13). Seventy-six percent of the patients, at the time of diagnosis, were stage III and IV. Most common metastatic sites were the liver, lymph nodes, bone, and lungs. Local recurrence developed in 39% of cases (15/38). Method: Forty-one patients underwent an operation. Complete surgical removal of all gross tumor was achieved in 24 patients. Result: The overall median survival time was 8 months, and the estimated 5-year survival rate 19%. There were significant differences in survival between the various stages (P = 0.01) and between the group of patients who underwent complete excision of the tumor and those with incomplete resection (P = 0.002). Conclusions: Complete surgical excision offers the best prospect for long-term survival in localized adrenal carcinoma. (C) 1994 Wiley-Liss, Inc.