The Prognostic Significance of Ipsilateral Adrenalectomy during Radical Nephrectomy for Renal Cell Carcinoma

Purpose: To review the result of a radical nephrectomy for renal cell carcinomas and investigate whether an ipsilateral adrenalectomy, during a radical nephrectomy, has a favorable prognostic effect in patients with renal cell carcinomas. Materials and Methods: The medical records of 365 patients, who underwent a radical nephrectomy, between January 1995 and December 1999, were retrospectively reviewed. All patients had unilateral renal cell carcinomas, and nephrectomies were performed either with (adrenalectomy group, 193 patients) or without (non-adrenalectomy group, 172 patients) an ipsilateral adrenalectomy. The survival rate was assessed using the Kaplan-Meier method. In conjunction with a univariate analysis, a multivariate analysis was performed, using a Cox regression analysis, to determine the independent prognostic factors. Results: The ages of the adrenalectomy and non-adrenalectomy groups ranged from 21 to 78 (mean age: 54.7 years) and 28 to 77 years (mean age: 54.0 years), respectively. The durations of the follow-up periods in the adrenalectomy and non-adrenalectomy groups were 62.4 and 62.6 months, respectively. There were no significant differences in the clinicopathological characteristics, including the T stage, between the two groups. The 3-year survival rates of the adrenalectomy and nonadrenalectomy group were 82.8 and 91.2%, respectively, and the 5-year survival rates were 75.4 and 85.3%, respectively (p=0.095). In the adrenalectomy group, distant metastasis, high T-stage and adrenal involvement were identified as prognostic factors by the multivariate statistical analysis (p=0.002, p=0.008 and p＜0.001, respectively). Conclusions: Our results reveal that an ipsilateral adrenalectomy, during a radical nephrectomy, does not improve the prognosis of patients with renal cell carcinomas.