Prognostic factors for recurrence-free and overall survival after adrenalectomy for metastatic carcinoma

A retrospective cohort pilot study

Eu Chang Hwang, Insang Hwang, Seung Il Jung, Taek Won Kang, Dong Deuk Kwon, Suk Hee Heo, Jun Eul Hwang, Sung-Gu Kang, Seok Ho Kang, Jeong Gu Lee, Je-Jong Kim, Jun Cheon

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background: The survival benefits of adrenalectomy (ADx) in the setting of metastatic cancer and prognostic factors for recurrence-free (RFS) and overall survival (OS) after adrenalectomy for metastatic carcinoma are still under debate. We evaluated the impact of clinicopathological variables on RFS and OS after ADx for metastatic carcinoma in patients with primary cancer. Methods. A total of 32 patients undergoing ADx for metastatic cancer between 2004 and 2012 at two tertiary medical centers. Metastases were regarded as synchronous (<6 months) or metachronous (≥6 months) depending on the interval after primary surgery. Associations of perioperative clinicopathologic variables with RFS and OS were analyzed using Cox regression models. Results: In total, 32 patients received ADx for metastatic primary tumors located in the lung (n = 11), colon (n = 4), liver (n = 5), stomach (n = 3), kidney (n = 4), pancreas (n = 2), glottis, esophagus, cervix, and ovary (n = 1 each). The overall recurrence rate after adrenalectomy was 62.5% (n = 20). By univariate analysis, C-reactive protein, inflammation-based prognosis score, and adrenalectomy for curative intent were associated with RFS and OS. Independent prognostic factors for shorter RFS were operative method (laparoscopy HR 4.68, 95% CI 1.61-13.61, p = 0.005) and inflammation-based prognostic score (HR 11.8, 95% CI 2.50-55.7, p = 0.002). For shorter OS, synchronous metastasis (HR 3.05, 95% CI 1.07-11.94, p = 0.048) and inflammation-based prognostic score (HR 6.65, 95% CI 1.25-35.23, p = 0.026) were identified as independent prognostic factors. Conclusions: Our pilot study suggests that synchronous disease and inflammation-based prognostic score are significant prognostic factors for survival and should be considered when performing ADx for metastatic diseases.

Original languageEnglish
Article number41
JournalBMC Urology
Volume14
Issue number1
DOIs
Publication statusPublished - 2014 May 23

Fingerprint

Adrenalectomy
Cohort Studies
Carcinoma
Recurrence
Survival
Inflammation
Neoplasms
Neoplasm Metastasis
Glottis
Proportional Hazards Models
Cervix Uteri
C-Reactive Protein
Laparoscopy
Esophagus
Pancreas
Ovary
Stomach
Colon
Kidney
Lung

Keywords

  • Adrenalectomy
  • Neoplasm metastasis
  • Prognosis
  • Survival

ASJC Scopus subject areas

  • Reproductive Medicine
  • Urology

Cite this

Prognostic factors for recurrence-free and overall survival after adrenalectomy for metastatic carcinoma : A retrospective cohort pilot study. / Hwang, Eu Chang; Hwang, Insang; Jung, Seung Il; Kang, Taek Won; Kwon, Dong Deuk; Heo, Suk Hee; Hwang, Jun Eul; Kang, Sung-Gu; Kang, Seok Ho; Lee, Jeong Gu; Kim, Je-Jong; Cheon, Jun.

In: BMC Urology, Vol. 14, No. 1, 41, 23.05.2014.

Research output: Contribution to journalArticle

Hwang, Eu Chang ; Hwang, Insang ; Jung, Seung Il ; Kang, Taek Won ; Kwon, Dong Deuk ; Heo, Suk Hee ; Hwang, Jun Eul ; Kang, Sung-Gu ; Kang, Seok Ho ; Lee, Jeong Gu ; Kim, Je-Jong ; Cheon, Jun. / Prognostic factors for recurrence-free and overall survival after adrenalectomy for metastatic carcinoma : A retrospective cohort pilot study. In: BMC Urology. 2014 ; Vol. 14, No. 1.
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abstract = "Background: The survival benefits of adrenalectomy (ADx) in the setting of metastatic cancer and prognostic factors for recurrence-free (RFS) and overall survival (OS) after adrenalectomy for metastatic carcinoma are still under debate. We evaluated the impact of clinicopathological variables on RFS and OS after ADx for metastatic carcinoma in patients with primary cancer. Methods. A total of 32 patients undergoing ADx for metastatic cancer between 2004 and 2012 at two tertiary medical centers. Metastases were regarded as synchronous (<6 months) or metachronous (≥6 months) depending on the interval after primary surgery. Associations of perioperative clinicopathologic variables with RFS and OS were analyzed using Cox regression models. Results: In total, 32 patients received ADx for metastatic primary tumors located in the lung (n = 11), colon (n = 4), liver (n = 5), stomach (n = 3), kidney (n = 4), pancreas (n = 2), glottis, esophagus, cervix, and ovary (n = 1 each). The overall recurrence rate after adrenalectomy was 62.5{\%} (n = 20). By univariate analysis, C-reactive protein, inflammation-based prognosis score, and adrenalectomy for curative intent were associated with RFS and OS. Independent prognostic factors for shorter RFS were operative method (laparoscopy HR 4.68, 95{\%} CI 1.61-13.61, p = 0.005) and inflammation-based prognostic score (HR 11.8, 95{\%} CI 2.50-55.7, p = 0.002). For shorter OS, synchronous metastasis (HR 3.05, 95{\%} CI 1.07-11.94, p = 0.048) and inflammation-based prognostic score (HR 6.65, 95{\%} CI 1.25-35.23, p = 0.026) were identified as independent prognostic factors. Conclusions: Our pilot study suggests that synchronous disease and inflammation-based prognostic score are significant prognostic factors for survival and should be considered when performing ADx for metastatic diseases.",
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T1 - Prognostic factors for recurrence-free and overall survival after adrenalectomy for metastatic carcinoma

T2 - A retrospective cohort pilot study

AU - Hwang, Eu Chang

AU - Hwang, Insang

AU - Jung, Seung Il

AU - Kang, Taek Won

AU - Kwon, Dong Deuk

AU - Heo, Suk Hee

AU - Hwang, Jun Eul

AU - Kang, Sung-Gu

AU - Kang, Seok Ho

AU - Lee, Jeong Gu

AU - Kim, Je-Jong

AU - Cheon, Jun

PY - 2014/5/23

Y1 - 2014/5/23

N2 - Background: The survival benefits of adrenalectomy (ADx) in the setting of metastatic cancer and prognostic factors for recurrence-free (RFS) and overall survival (OS) after adrenalectomy for metastatic carcinoma are still under debate. We evaluated the impact of clinicopathological variables on RFS and OS after ADx for metastatic carcinoma in patients with primary cancer. Methods. A total of 32 patients undergoing ADx for metastatic cancer between 2004 and 2012 at two tertiary medical centers. Metastases were regarded as synchronous (<6 months) or metachronous (≥6 months) depending on the interval after primary surgery. Associations of perioperative clinicopathologic variables with RFS and OS were analyzed using Cox regression models. Results: In total, 32 patients received ADx for metastatic primary tumors located in the lung (n = 11), colon (n = 4), liver (n = 5), stomach (n = 3), kidney (n = 4), pancreas (n = 2), glottis, esophagus, cervix, and ovary (n = 1 each). The overall recurrence rate after adrenalectomy was 62.5% (n = 20). By univariate analysis, C-reactive protein, inflammation-based prognosis score, and adrenalectomy for curative intent were associated with RFS and OS. Independent prognostic factors for shorter RFS were operative method (laparoscopy HR 4.68, 95% CI 1.61-13.61, p = 0.005) and inflammation-based prognostic score (HR 11.8, 95% CI 2.50-55.7, p = 0.002). For shorter OS, synchronous metastasis (HR 3.05, 95% CI 1.07-11.94, p = 0.048) and inflammation-based prognostic score (HR 6.65, 95% CI 1.25-35.23, p = 0.026) were identified as independent prognostic factors. Conclusions: Our pilot study suggests that synchronous disease and inflammation-based prognostic score are significant prognostic factors for survival and should be considered when performing ADx for metastatic diseases.

AB - Background: The survival benefits of adrenalectomy (ADx) in the setting of metastatic cancer and prognostic factors for recurrence-free (RFS) and overall survival (OS) after adrenalectomy for metastatic carcinoma are still under debate. We evaluated the impact of clinicopathological variables on RFS and OS after ADx for metastatic carcinoma in patients with primary cancer. Methods. A total of 32 patients undergoing ADx for metastatic cancer between 2004 and 2012 at two tertiary medical centers. Metastases were regarded as synchronous (<6 months) or metachronous (≥6 months) depending on the interval after primary surgery. Associations of perioperative clinicopathologic variables with RFS and OS were analyzed using Cox regression models. Results: In total, 32 patients received ADx for metastatic primary tumors located in the lung (n = 11), colon (n = 4), liver (n = 5), stomach (n = 3), kidney (n = 4), pancreas (n = 2), glottis, esophagus, cervix, and ovary (n = 1 each). The overall recurrence rate after adrenalectomy was 62.5% (n = 20). By univariate analysis, C-reactive protein, inflammation-based prognosis score, and adrenalectomy for curative intent were associated with RFS and OS. Independent prognostic factors for shorter RFS were operative method (laparoscopy HR 4.68, 95% CI 1.61-13.61, p = 0.005) and inflammation-based prognostic score (HR 11.8, 95% CI 2.50-55.7, p = 0.002). For shorter OS, synchronous metastasis (HR 3.05, 95% CI 1.07-11.94, p = 0.048) and inflammation-based prognostic score (HR 6.65, 95% CI 1.25-35.23, p = 0.026) were identified as independent prognostic factors. Conclusions: Our pilot study suggests that synchronous disease and inflammation-based prognostic score are significant prognostic factors for survival and should be considered when performing ADx for metastatic diseases.

KW - Adrenalectomy

KW - Neoplasm metastasis

KW - Prognosis

KW - Survival

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