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489 Impact of primary histology on oncologic outcomes after minimally invasive adrenalectomy for metastatic cancer
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Impact of primary histology on oncologic outcomes after minimally invasive adrenalectomy for metastatic cancer Eur Urol Suppl 2016;15(3);e489
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Ferriero M.C., Simone G., Papalia R., Mastroianni R., Guaglianone S., Gallucci M. "Regina Elena" National Cancer Institute, Dept. of Urology, Rome, Italy INTRODUCTION & OBJECTIVES: The adrenal gland is a site of metastasis for several malignancies. Metastasectomy with the achievement of a no evidence of disease (NED) status demonstrated to positively impact the oncological outcome. We report oncologic results of a single centre 10-year experience with minimally invasive adrenalectomy for isolated adrenal metastasis. MATERIAL & METHODS: From May 2004 to October 2014, 162 patients underwent laparoscopic or robotic adrenalectomy. Pathological examination showed a metastasis in 36 patients. All cases with sincronous metastasis were excluded. Baseline demographics, perioperative and follow up data were prospectively collected. Univariable and multivariable cox regression analyses were performed to identify predictors of disease recurrence. RESULTS: Median follow up was 28 months. Tumor histology was renal cell carcinoma (RCC) in 27 patients (75%). (Table 1) At univariable analysis bilateral adrenalectomy and primary tumor histology were predictors of recurrence free survival (RFS) (p=0.048 and p=0.003, respectively). At multivariable cox analysis the only independent predictor of RFS was primary tumor histology (p=0.008). Lung cancer displayed similar survival compared to RCC (reference category), while colon cancer (p=0.021; HR 7.08 [95% CI 0.96-1.28]), bladder cancer (p=0.001; HR102.6 [95% CI 7.3-1440]) and melanoma (p=0.01; HR 26.3 [95% CI 2.17-319], were associated with increased risk of disease recurrence. Table 1
DATA Age Side Right Left Bilateral Histology ccRCC Lung Urothelial Carcinoma Colon adenocarcinoma Melanoma Tumour size (cm) Adrenal size (cm)
Mean (SD) or N (%) 56 (25) 14 (38.8) 16 (44.4) 6 (16.8) 27 (75) 4 (11.1) 2 (5.5) 2 (5.5) 1 (2.7) 5.4 (2.9) 6.2 (2.7)
CONCLUSIONS: Oncologic outcomes after adrenalectomy for metastatic cancer mainly depends on the primary tumor histology.
Impact of primary histology on oncologic outcomes after minimally invasive adrenalectomy for metastatic cancer Eur Urol Suppl 2016;15(3);e489
Print! Print!
Ferriero M.C., Simone G., Papalia R., Mastroianni R., Guaglianone S., Gallucci M. "Regina Elena" National Cancer Institute, Dept. of Urology, Rome, Italy INTRODUCTION & OBJECTIVES: The adrenal gland is a site of metastasis for several malignancies. Metastasectomy with the achievement of a no evidence of disease (NED) status demonstrated to positively impact the oncological outcome. We report oncologic results of a single centre 10-year experience with minimally invasive adrenalectomy for isolated adrenal metastasis. MATERIAL & METHODS: From May 2004 to October 2014, 162 patients underwent laparoscopic or robotic adrenalectomy. Pathological examination showed a metastasis in 36 patients. All cases with sincronous metastasis were excluded. Baseline demographics, perioperative and follow up data were prospectively collected. Univariable and multivariable cox regression analyses were performed to identify predictors of disease recurrence. RESULTS: Median follow up was 28 months. Tumor histology was renal cell carcinoma (RCC) in 27 patients (75%). (Table 1) At univariable analysis bilateral adrenalectomy and primary tumor histology were predictors of recurrence free survival (RFS) (p=0.048 and p=0.003, respectively). At multivariable cox analysis the only independent predictor of RFS was primary tumor histology (p=0.008). Lung cancer displayed similar survival compared to RCC (reference category), while colon cancer (p=0.021; HR 7.08 [95% CI 0.96-1.28]), bladder cancer (p=0.001; HR102.6 [95% CI 7.3-1440]) and melanoma (p=0.01; HR 26.3 [95% CI 2.17-319], were associated with increased risk of disease recurrence. Table 1
DATA Age Side Right Left Bilateral Histology ccRCC Lung Urothelial Carcinoma Colon adenocarcinoma Melanoma Tumour size (cm) Adrenal size (cm)
Mean (SD) or N (%) 56 (25) 14 (38.8) 16 (44.4) 6 (16.8) 27 (75) 4 (11.1) 2 (5.5) 2 (5.5) 1 (2.7) 5.4 (2.9) 6.2 (2.7)
CONCLUSIONS: Oncologic outcomes after adrenalectomy for metastatic cancer mainly depends on the primary tumor histology.