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Reconsidering the necessity of ipsilateral adrenalectomy during radical nephrectomy for renal cell carcinoma.
- Source :
-
Urology [Urology] 1995 Sep; Vol. 46 (3), pp. 316-20. - Publication Year :
- 1995
-
Abstract
- Objectives: Ipsilateral adrenalectomy is traditionally advocated as part of radical nephrectomy performed for renal cell carcinoma. The current study addresses the controversy of whether ipsilateral adrenalectomy should be performed routinely during radical nephrectomy.<br />Methods: A total of 225 patients were treated surgically for renal cell carcinoma over an 18-year period. Of these patients, 158 underwent nephrectomy and simultaneous ipsilateral adrenalectomy and the other 67 had sparing of the ipsilateral adrenal gland. A retrospective analysis of the medical records and assessment of the clinical and the pathologic data were performed. Rates of survival and progression were evaluated in a subgroup of 109 patients, further subdivided into 54 patients who underwent concomitant adrenalectomy and 55 patients with the ipsilateral adrenal preserved during surgery.<br />Results: Histopathologic abnormalities were detected in seven adrenal specimens (4.4%); however, only 3 patients (1.9%) had involvement of the adrenal by renal cell carcinoma. All cases of adrenal involvement were detected by the preoperative imaging modalities. Ipsilateral adrenalectomy did not improve the outcome in comparison to adrenal preservation.<br />Conclusions: In view of the rarity of ipsilateral adrenal metastasis, the questionable prognostic merits of concomitant adrenalectomy, and the availability of accurate imaging modalities, we conclude that ipsilateral adrenalectomy is not necessary in the majority of the patients undergoing radical nephrectomy for renal cell carcinoma.
- Subjects :
- Adenoma diagnosis
Adenoma surgery
Adrenal Gland Neoplasms diagnosis
Adrenal Gland Neoplasms mortality
Adrenal Gland Neoplasms secondary
Adult
Aged
Aged, 80 and over
Carcinoma, Renal Cell diagnosis
Carcinoma, Renal Cell mortality
Carcinoma, Renal Cell secondary
Female
Follow-Up Studies
Humans
Kidney Neoplasms diagnosis
Kidney Neoplasms mortality
Male
Middle Aged
Neoplasm Recurrence, Local
Neoplasm Staging
Prognosis
Retrospective Studies
Sensitivity and Specificity
Survival Rate
Tomography, X-Ray Computed
Adrenalectomy
Carcinoma, Renal Cell surgery
Kidney Neoplasms surgery
Nephrectomy methods
Subjects
Details
- Language :
- English
- ISSN :
- 0090-4295
- Volume :
- 46
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Urology
- Publication Type :
- Academic Journal
- Accession number :
- 7660505
- Full Text :
- https://doi.org/10.1016/S0090-4295(99)80213-1