Adrenal Metastasectomy in the Era of Immuno- and Targeted Therapy

Heather Wachtel, Paxton Dickson, Sarah B. Fisher, Colleen M. Kiernan, Carmen C. Solórzano

Research output: Contribution to journalReview articlepeer-review

3 Scopus citations

Abstract

Adrenal metastasectomy has an increasing role in multimodality oncologic care for diverse primary cancer types. In this review, we discuss the epidemiology, evaluation, and contemporary best practices in the management of adrenal metastases from various primaries. Initial evaluation of suspected adrenal metastases should include diagnostic imaging to assess the extent of tumor involvement and determine surgical resectability, as well as biochemical evaluation for hormone secretion. Biopsy has a minimal role and should only be performed in tumors that are established to be non-hormone secreting and when the biopsy results would change clinical management. Adrenal metastasectomy is associated with survival benefit in selected patients. We suggest that adrenal metastasectomy has the greatest benefit in four clinical scenarios: (1) disease limited to the adrenal gland in which adrenalectomy renders the patient disease-free; (2) isolated progression in the adrenal gland in the setting of otherwise controlled metastatic extra-adrenal disease; (3) need for palliation of symptoms related to adrenal metastases; or (4) in the context of tissue-based clinical trials. Both minimally invasive and open adrenalectomy techniques are safe and appear to have equivalent oncologic outcomes. Minimally invasive approaches are favored when technically feasible while maintaining oncologic principles. A multidisciplinary evaluation including clinicians with expertise in the primary cancer type is essential to the successful management of adrenal metastases.

Original languageEnglish (US)
Pages (from-to)4146-4155
Number of pages10
JournalAnnals of surgical oncology
Volume30
Issue number7
DOIs
StatePublished - Jul 2023

ASJC Scopus subject areas

  • Surgery
  • Oncology

Fingerprint

Dive into the research topics of 'Adrenal Metastasectomy in the Era of Immuno- and Targeted Therapy'. Together they form a unique fingerprint.

Cite this