Cirugía de las metástasis suprarrenales

2021 
BACKGROUND Adrenal metastases are the most common malignant lesions of the adrenal glands and the second most common tumor after adenomas. The location of the primary tumor is described: lung (39%), breast (35%), gastrointestinal tract, among other. Several studies show that surgery improves survival in selected cases. METHOD Retrospective and single-center observational study of patients operated for adrenal metastasis over a period of 11 years. The characteristics of the disease and surgical results were described. RESULTS 14 suprarenalectomies were performed. The average age was 65.85 years. The primary tumors described: non-small cell lung carcinoma (42.8%) and clear cell renal carcinoma (14.20%). In 92.8% the injury was unilateral. In 64.2% it was metachronous. An initial laparoscopic approach was performed in 85.71%. The morbidity of our series was 14.28%. The median overall survival was 30 months. Survival was 75% per year, 55.5% at 3 years and 40% at 5 years. CONCLUSIONS Age, primary location, degree of differentiation, histological type, size greater, laterality, disease-free interval, chemotherapy and surgical technique are not associated with changes in survival. In the presence of a single adrenal mass, surgical evaluation is mandatory and surgery could play a role in patients with metastases in other locations with control of the primary disease.
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