Digestive surgery · 2015
Resection of metachronous adrenal metastasis after liver resection and transplantation for hepatocellular carcinoma.
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Ha Tae-Yong, Hwang Shin, Ahn Chul-Soo, Kim Ki-Hun, Lee Young-Joo, Moon Deok-Bog, Song Gi-Won, Jung Dong-Hwan, Park Gil-Chun, Lee Sung-Gyu
Аннотация
BACKGROUND: This study analyzed the patient survival outcomes following the resection of hepatocellular carcinoma (HCC) metachronous adrenal metastasis (MAM) in patients who had undergone liver resection or liver transplantation (LT).
METHODS: Clinical results were analyzed retrospectively in 26 patients with MAM-HCC who underwent adrenalectomy.
RESULTS: The mean interval between initial surgery and adrenalectomy was significantly shorter in the resection group than in the LT group (18.3 ± 14.4 vs. 42.6 ± 13.8 months, p < 0.001). Of 19 resected patients, four had adrenal metastases on the right side, 12 on the left side and three bilaterally, with a mean tumor diameter of 3.6 ± 1.5 cm. Ten of these patients underwent open surgery and nine underwent laparoscopic surgery; all patients experienced recurrences within 18 months and 20.3% survived 5 years after adrenalectomy. Of 7 patients who underwent LT, four had adrenal metastases on the right side and three on the left side, with a mean tumor diameter of 3.4 ± 1.8 cm. Six of these patients underwent open surgery and one underwent laparoscopic surgery. Five-year recurrence and patient survival rates after adrenalectomy were 28.6 and 85.7%, respectively.
CONCLUSIONS: Adrenalectomy is indicated in patients with isolated MAM-HCC. Comparisons with other locoregional treatment modalities and multicenter studies with additional patients are needed to validate the role of adrenalectomy.
METHODS: Clinical results were analyzed retrospectively in 26 patients with MAM-HCC who underwent adrenalectomy.
RESULTS: The mean interval between initial surgery and adrenalectomy was significantly shorter in the resection group than in the LT group (18.3 ± 14.4 vs. 42.6 ± 13.8 months, p < 0.001). Of 19 resected patients, four had adrenal metastases on the right side, 12 on the left side and three bilaterally, with a mean tumor diameter of 3.6 ± 1.5 cm. Ten of these patients underwent open surgery and nine underwent laparoscopic surgery; all patients experienced recurrences within 18 months and 20.3% survived 5 years after adrenalectomy. Of 7 patients who underwent LT, four had adrenal metastases on the right side and three on the left side, with a mean tumor diameter of 3.4 ± 1.8 cm. Six of these patients underwent open surgery and one underwent laparoscopic surgery. Five-year recurrence and patient survival rates after adrenalectomy were 28.6 and 85.7%, respectively.
CONCLUSIONS: Adrenalectomy is indicated in patients with isolated MAM-HCC. Comparisons with other locoregional treatment modalities and multicenter studies with additional patients are needed to validate the role of adrenalectomy.