Adrenalectomy for Solitary Adrenal Gland Metastases

The Use of Adrenalectomy in Patients With Solitary Adrenal Gland Metastases

The adrenal glands are one of the most common organs involved in metastatic disease. Metastases are the second most common type of adrenal mass, second only to adenomas. It is a frequent finding during autopsy with a reported rate as high as 27% in patients with known primary malignancy. Although several studies have found an increased survival in patients who undergo resection of solitary adrenal metastases the indications for adrenalectomy in cases of metastatic adrenal tumor remain controversial. Collinson et al reported an increased survival in patients with melanoma. Median survival was 16 months for patients who underwent adrenalectomy compared to 5 months for patients with documented adrenal metastases treated non surgically.

The aim of this study is to compare retrospectively in case and control study, performing adrenalectomy, open or laparoscopic, versus supportive treatment for patients with solitary adrenal gland metastases. The investigators will review charts of patients between January 1994 and November 2009 who had adrenal gland metastases. The variables the inevstigators will compare are mortality, morbidity, primary tumour sites, histological cell type, age, tumour size, presence of synchronous metastases, mean time from diagnosis of primary tumor to treatment of adrenal metastases, indication for adrenalectomy, partial versus total adrenalectomy, suspected versus confirmed metastatic disease.

Study Overview

• Status: Completed
• Conditions: Adrenal Gland Metastases; Adrenalectomy

• Study Type: Observational
• Enrollment (Actual): 168

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Patients undergoing adrenalectomy for metastatic disease.

Description

Inclusion Criteria:

• Metastatic disease to the adrenal gland

Exclusion Criteria:

• Primary adrenal neoplasm

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Adrenalectomy improves overall survival in patients with solitary metastasis	Survival data compared to historic controls	25 years

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Adrenalectomy can be performed with minimal morbidity in patients with metastatic lesions to the adrenal gland.	Operative outcomes compared to historic control patients undergoing adrenalectomy for non-maligant disorders.	25 years

Collaborators and Investigators

• Sponsor: Mayo Clinic
• Investigators: Principal Investigator: Melanie L Richards, MD, Mayo Clinic

Study record dates

Study Major Dates

• Study Start: November 1, 2009
• Primary Completion (Actual): November 1, 2010
• Study Completion (Actual): November 1, 2010

Study Registration Dates

• First Submitted: June 1, 2010
• First Submitted That Met QC Criteria: June 1, 2010
• First Posted (Estimate): June 2, 2010

Study Record Updates

• Last Update Posted (Estimate): December 16, 2011
• Last Update Submitted That Met QC Criteria: December 14, 2011
• Last Verified: December 1, 2011

More Information

Terms related to this study

• Keywords: survival; mortality; metastasis; morbidity; adrenalectomy
• Additional Relevant MeSH Terms: Pathologic Processes; Neoplasms; Neoplasms by Site; Endocrine System Diseases; Endocrine Gland Neoplasms; Neoplastic Processes; Adrenal Gland Diseases; Neoplasm Metastasis; Adrenal Gland Neoplasms
• Other Study ID Numbers: 09-007747