[Kidney cancer XXXX to the adrenal gland. Role of adrenalectomy].

@entity1 @entity66 @entity1358 @entity3 @entity774
We analysed case records of 2507 @entity1 with @entity1358 treated in the department of onco-urology of Cancer Research Center (Moscow). 1939 of them underwent nephrectomy between 1971 and 1999. The overall incidence of adrenal metastases according to CT and histological findings was 4.7%. Synchronous metastases occurred in 90 and metachronous ones in 30 @entity1 . Radical nephrectomy with adrenalectomy was performed in 18 out of 90 @entity1 with synchronous metastases, palliative nephrectomy in 20 and 52 @entity1 were not considered for surgery. Among 18 @entity1 who underwent complete surgical resection, 12(66%) had either lymph node involvement or distant metastases. A microscopic @entity3 was found on histological examination only in 1 @entity1 with normal CT scan and macroscopically intact adrenal on intraoperative assessment. Mean survival after radical nephrectomy with adrenalectomy in 6 @entity1 with solitary lesions was 57 months compared to the longest survival of 31 months in @entity1 with @entity66 . Solitary metachronous ipsilateral and contralateral adrenal involvement was present in 7 @entity1 . The average interval between nephrectomy and appearance of adrenal @entity3 in this group was 73 months. One @entity1 was lost for follow-up and one died of @entity774 4.3 months after adrenalectomy. One @entity1 underwent a consecutive removal of brain and lung metastases 33 and 38 months following adrenalectomy while the remaining 4 were alive in 15, 16, 26 and 34 months with no evidence of the disease. Thus, ipsilateral adrenalectomy is obligatory only in @entity1 with severe disease as shown by CT scan or at nephrectomy. About one-third of the @entity1 will benefit from the surgery. Adrenalectomy should be performed in case of obvious adrenal involvement. The aggressive surgical approach is justified in solitary metachronous adrenal involvement because of long-term survival expected in some of such @entity1 .
