Our Summary

This study looks at the success of a certain type of surgery, laparoscopic adrenalectomy (LA), in treating adrenal metastases (cancerous tumors in the adrenal glands) in cancer patients. This type of surgery is usually used for benign (non-cancerous) tumors, but its effectiveness in treating malignant (cancerous) tumors is still being debated.

The researchers studied 17 patients with adrenal metastases who underwent LA between 2007 and 2019, looking at things like the size of the tumor, any complications from the surgery, and whether the cancer came back.

The study found that the surgery was generally successful, with a relatively low rate of complications and acceptable results in terms of cancer outcomes. The median survival time after the surgery was 24 months, and 61.4% of patients were still alive five years after the surgery.

Interestingly, patients whose metastases appeared more than six months after their primary tumor (metachronous metastases) had better survival rates than those whose metastases appeared within six months of their primary tumor (synchronous metastases).

The researchers conclude that LA could be a good treatment option for certain patients with adrenal metastases, especially those with metachronous metastases, but that each case needs to be evaluated individually.

FAQs

  1. What is a laparoscopic adrenalectomy and what is it typically used for?
  2. What were the main findings of this study on the use of laparoscopic adrenalectomy for treating adrenal metastases?
  3. What is the difference between metachronous and synchronous metastases, and how did they affect the survival rates of patients in the study?

Doctor’s Tip

A doctor might tell a patient undergoing adrenalectomy to make sure to follow all pre-operative instructions, such as fasting before surgery and stopping certain medications. They may also advise the patient to discuss any concerns or questions they have with their healthcare team, as well as to follow post-operative care instructions carefully to aid in a successful recovery. Additionally, the doctor may recommend regular follow-up appointments to monitor the patient’s progress and ensure the best possible outcome.

Suitable For

Patients who may be recommended for adrenalectomy include those with adrenal tumors that are causing symptoms such as hormone overproduction (e.g. Cushing’s syndrome, Conn’s syndrome, pheochromocytoma), those with benign adrenal tumors that are growing in size, and potentially those with adrenal metastases from certain types of cancer, as shown in the study discussed above. Ultimately, the decision to recommend adrenalectomy will depend on the specific characteristics of the tumor, the patient’s overall health, and the potential benefits and risks of surgery.

Timeline

Before adrenalectomy:

  1. Patient is diagnosed with adrenal metastases through imaging tests such as CT scans or MRIs.
  2. Oncologist evaluates the patient’s overall health and determines if they are a candidate for surgery.
  3. Patient undergoes pre-operative tests and preparations, such as blood work and medical clearance.
  4. Surgery date is scheduled and patient receives instructions on how to prepare, such as fasting before the procedure.

After adrenalectomy:

  1. Patient undergoes laparoscopic adrenalectomy surgery to remove the cancerous tumor from the adrenal gland.
  2. Recovery period in the hospital, typically 1-2 days, where patient is monitored for any complications.
  3. Patient is discharged from the hospital and instructed on post-operative care, such as wound care and pain management.
  4. Follow-up appointments with the surgeon and oncologist to monitor recovery and discuss further treatment options.
  5. Ongoing monitoring for cancer recurrence through imaging tests and blood work.
  6. Patient may undergo additional treatments such as chemotherapy or radiation therapy depending on the cancer stage and type.
  7. Patients may experience improvements in symptoms related to the adrenal metastases and have a better quality of life post-surgery.

What to Ask Your Doctor

Some questions a patient may consider asking their doctor about adrenalectomy for adrenal metastases include:

  1. What are the potential risks and complications associated with laparoscopic adrenalectomy for treating adrenal metastases?
  2. How will the surgery impact my overall cancer treatment plan and prognosis?
  3. How experienced is the surgical team in performing laparoscopic adrenalectomy for adrenal metastases?
  4. Are there any alternative treatment options available for treating adrenal metastases, and how do they compare to surgery?
  5. What is the expected recovery time and post-operative care following adrenalectomy?
  6. Will I need any additional treatments, such as chemotherapy or radiation therapy, after the surgery?
  7. How will the surgery impact my quality of life and long-term health outcomes?
  8. What are the chances of the cancer recurring after adrenalectomy, and how will this be monitored?
  9. Are there any lifestyle changes or precautions I should take following the surgery to prevent complications or recurrence of the cancer?
  10. Can you provide me with more information or resources about laparoscopic adrenalectomy and its success rates in treating adrenal metastases?

Reference

Authors: Quildrian SD, Nardi WS, Iriarte F, Recalde M, Califano I, Chapela J. Journal: Surg Endosc. 2023 Jun;37(6):4651-4657. doi: 10.1007/s00464-023-09961-4. Epub 2023 Mar 3. PMID: 36869264