Surgery for adrenal metastasis: surgical outcomes and prognostic factors for long-term survival.

PURPOSE: To analyze surgical outcomes and predictive factors for long-term overall and disease-specific survival in patients undergoing surgical resection of adrenal metastasis.

METHODS: A multicenter retrospective study included patients who underwent adrenalectomy for adrenal metastasis in two Spanish hospitals between 2005 and 2021. Clinical variables associated with surgical complications and survival during follow-up were analyzed.

RESULTS: Thirty-three patients were included. Adrenalectomy was performed laparoscopically in 27 patients and by an open approach in 6. The most common primary tumor site was the lung (n=15), followed by the kidney (n=7). Most patients had metachronous lesions (n=28). Six patients (18.2%) had intra- and/or post-operative complications; synchronous metastasis was a risk factor (odds ratio (OR) 12.5 [1.45-107.6]). Progression-free survival and disease-specific survival were 7.5 months (range 1-64) and 22.5 months (6-120), respectively. Survival rates at 1, 2, 3 and 5 years were 94%, 65%, 48% and 29%, respectively. Survival was significantly lower in patients with lung cancer than with other cancers (hazard ratio 4.23 [1.42-12.59]).

CONCLUSIONS: Adrenalectomy for solitary adrenal metastases was associated with intra- or post-operative complications in 18% of cases. Synchronous metastasis was a risk factor for complications.