The outcomes of adrenalectomy for solitary adrenal metastasis: A 17-year single-center experience

Aim We aimed to analyze surgical outcomes of open or laparoscopic adrenalectomy for solitary adrenal metastasis and assess the factors influencing survival. Methods We retrospectively reviewed our institutional clinicopathological database for cases of adrenalectomy for solitary adrenal metastasis from solid tumors between 2000 and 2017. Results Twenty-five patients underwent open adrenalectomy (n = 11) or laparoscopic adrenalectomy (n = 14). The most common primary site was the lung (n = 7), followed by the kidney (n = 5), liver (n = 3), ovary (n = 2), soft tissue (n = 2), and six other sites. The majority of the patients (n = 19) had metachronous metastasis. The median tumor size was 3.1 cm (1-9 cm). With the median follow-up of 32 months (2-144 months), the median progression-free and overall survivals were 14 and 63 months, respectively. Multivariate analysis revealed that synchronous metastasis (hazard ratio [HR] = 7.5) and tumor size >= 4 cm (HR = 17.7) were significant prognostic factors for shorter overall survival. There was no significant difference for survival between the laparoscopic and open groups. Conclusions Adrenalectomy for solitary adrenal metastasis can be applied for selected patients with various types of malignancy. However, synchronous metastasis and tumor size >= 4 cm were prognostic factors for shorter overall survival.