Outcomes after Surgical Treatment of Metastatic Disease in the Adrenal Gland; Valuable for the Patient?
The adrenal glands are common dissemination sites for metastasis of various solid tumors. Surgical treatment is often recommended because targeted therapies and immunotherapy are frequently ineffective for adrenal metastasis. We report the experience with short-term and long-term surgical outcomes o...
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| Format: | Article |
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MDPI AG
2021-12-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/14/1/156 |
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| author | Madelon J. H. Metman Charlotte L. Viëtor Auke J. Seinen Annika M. A. Berends Patrick H. J. Hemmer Michiel N. Kerstens Richard A. Feelders Gaston J. H. Franssen Tessa M. van Ginhoven Schelto Kruijff |
| author_facet | Madelon J. H. Metman Charlotte L. Viëtor Auke J. Seinen Annika M. A. Berends Patrick H. J. Hemmer Michiel N. Kerstens Richard A. Feelders Gaston J. H. Franssen Tessa M. van Ginhoven Schelto Kruijff |
| author_sort | Madelon J. H. Metman |
| collection | DOAJ |
| description | The adrenal glands are common dissemination sites for metastasis of various solid tumors. Surgical treatment is often recommended because targeted therapies and immunotherapy are frequently ineffective for adrenal metastasis. We report the experience with short-term and long-term surgical outcomes of patients undergoing surgery for adrenal metastasis in two hospitals. A retrospective, multicenter study was performed to analyze patient characteristics, tumor-related data, perioperative outcomes, and oncological outcomes. Postoperative complications that occurred within 30 days were scored according to the Clavien Dindo classification. Metastatic adrenalectomy was performed in 95 patients. We observed an increase from an average of 3 metastatic adrenalectomies per year between 2001–2005 to 10 between 2015–2019. The most frequent underlying malignancies were colorectal and lung cancer. In 55.8%, minimal invasive adrenalectomy was performed, including six conversions to open surgery. A total of 37.9% of patients had postoperative complications, of which ileus or gastroparesis, wound problems, pneumonia, and heart arrhythmias were the most occurring complications. Improved cancer care has led to an increased demand for metastatic adrenalectomy over the past years. Complication rates of 37.9% are significant and cannot be neglected. Therefore, multidisciplinary teams should weigh the decision to perform metastatic adrenalectomy for each patient individually, taking into account the drawbacks of the described morbidity versus the potential benefits. |
| first_indexed | 2024-03-10T03:47:42Z |
| format | Article |
| id | doaj.art-d426f586bed140748f068ceeb3133794 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T03:47:42Z |
| publishDate | 2021-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-d426f586bed140748f068ceeb31337942023-11-23T11:16:59ZengMDPI AGCancers2072-66942021-12-0114115610.3390/cancers14010156Outcomes after Surgical Treatment of Metastatic Disease in the Adrenal Gland; Valuable for the Patient?Madelon J. H. Metman0Charlotte L. Viëtor1Auke J. Seinen2Annika M. A. Berends3Patrick H. J. Hemmer4Michiel N. Kerstens5Richard A. Feelders6Gaston J. H. Franssen7Tessa M. van Ginhoven8Schelto Kruijff9Department of Surgical Oncology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The NetherlandsDepartment of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC Cancer Institute, Doctor Molewaterplein 40, 3015 GD Rotterdam, The NetherlandsDepartment of Surgical Oncology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The NetherlandsDepartment of Endocrinology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The NetherlandsDepartment of Surgical Oncology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The NetherlandsDepartment of Endocrinology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The NetherlandsDepartment of Endocrinology, Erasmus MC Cancer Institute, Doctor Molewaterplein 40, 3015 GD Rotterdam, The NetherlandsDepartment of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC Cancer Institute, Doctor Molewaterplein 40, 3015 GD Rotterdam, The NetherlandsDepartment of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC Cancer Institute, Doctor Molewaterplein 40, 3015 GD Rotterdam, The NetherlandsDepartment of Surgical Oncology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The NetherlandsThe adrenal glands are common dissemination sites for metastasis of various solid tumors. Surgical treatment is often recommended because targeted therapies and immunotherapy are frequently ineffective for adrenal metastasis. We report the experience with short-term and long-term surgical outcomes of patients undergoing surgery for adrenal metastasis in two hospitals. A retrospective, multicenter study was performed to analyze patient characteristics, tumor-related data, perioperative outcomes, and oncological outcomes. Postoperative complications that occurred within 30 days were scored according to the Clavien Dindo classification. Metastatic adrenalectomy was performed in 95 patients. We observed an increase from an average of 3 metastatic adrenalectomies per year between 2001–2005 to 10 between 2015–2019. The most frequent underlying malignancies were colorectal and lung cancer. In 55.8%, minimal invasive adrenalectomy was performed, including six conversions to open surgery. A total of 37.9% of patients had postoperative complications, of which ileus or gastroparesis, wound problems, pneumonia, and heart arrhythmias were the most occurring complications. Improved cancer care has led to an increased demand for metastatic adrenalectomy over the past years. Complication rates of 37.9% are significant and cannot be neglected. Therefore, multidisciplinary teams should weigh the decision to perform metastatic adrenalectomy for each patient individually, taking into account the drawbacks of the described morbidity versus the potential benefits.https://www.mdpi.com/2072-6694/14/1/156adrenal metastasisadrenalectomytreatment managementpatient-tailored treatment |
| spellingShingle | Madelon J. H. Metman Charlotte L. Viëtor Auke J. Seinen Annika M. A. Berends Patrick H. J. Hemmer Michiel N. Kerstens Richard A. Feelders Gaston J. H. Franssen Tessa M. van Ginhoven Schelto Kruijff Outcomes after Surgical Treatment of Metastatic Disease in the Adrenal Gland; Valuable for the Patient? Cancers adrenal metastasis adrenalectomy treatment management patient-tailored treatment |
| title | Outcomes after Surgical Treatment of Metastatic Disease in the Adrenal Gland; Valuable for the Patient? |
| title_full | Outcomes after Surgical Treatment of Metastatic Disease in the Adrenal Gland; Valuable for the Patient? |
| title_fullStr | Outcomes after Surgical Treatment of Metastatic Disease in the Adrenal Gland; Valuable for the Patient? |
| title_full_unstemmed | Outcomes after Surgical Treatment of Metastatic Disease in the Adrenal Gland; Valuable for the Patient? |
| title_short | Outcomes after Surgical Treatment of Metastatic Disease in the Adrenal Gland; Valuable for the Patient? |
| title_sort | outcomes after surgical treatment of metastatic disease in the adrenal gland valuable for the patient |
| topic | adrenal metastasis adrenalectomy treatment management patient-tailored treatment |
| url | https://www.mdpi.com/2072-6694/14/1/156 |
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