Adrenalectomy does not improve survival rates of patients with solitary adrenal metastasis from non-small cell lung cancer

Shao-Hong Huang,1,* Qing-Lei Kong,2,* Xue-Xia Chen,3 Jin-Yuan He,1 Jie Qin,4 Zhuang-Gui Chen5,6 1Department of Cardiothoracic Surgery, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; 2Department of Emergency, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; 3Department of Nursing, Eastern Hospital of The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; 4Department of Radiology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; 5Department of Pediatrics, Pediatric Intensive Care Unit, The Third Affiliated Hospital of Sun Yat-sen University, 6Institution of Respiratory Disease of Sun Yat-sen University, Guangzhou, China *These authors contributed equally to this work Background and purpose: Several case reports and studies have suggested that there is an increased survival rate for patients who undergo resection of solitary adrenal metastasis from non-small cell lung cancer (NSCLC). This study aimed to investigate whether NSCLC patients with solitary adrenal metastasis could gain a higher survival rate after adrenalectomy (ADX) when compared with those patients undergoing nonsurgical treatment, and to investigate the potential prognostic factors.Patients and methods: A total of 1,302 NSCLC inpatients’ data from 2001 to 2015 were retrospectively reviewed to identify those with solitary adrenal metastasis. Overall survival for those who underwent both primary resection and ADX was compared to those patients with conservative treatment using the log-rank test. Potential prognostic variables were evaluated with univariate and multivariate analyses including clinical, therapeutic, pathologic, primary and metastatic data.Results: A total of 22 NSCLC patients with solitary adrenal metastasis were identified, with an overall median survival of 11 months (95% confidence interval: 9.4–12.6 months) and a 1-year survival rate of 51.4% (95% confidence interval: 29.6%&amp