AB143. SOH23ABS_144. Adrenalectomy for metastatic disease: feasible but futile?

Background: The incidence of isolated adrenal metastases has increased with the routine use of high resolution imaging for oncological surveillance. Several case series reported improved survival after a surgical adrenalectomy in selected patients with oligometastatic disease. However, it is unclear which patients will benefit with a long term survival. We evaluated the oncological outcomes of patients who underwent adrenal metastasectomy at our institution.

Methods: A prospectively maintained adrenal database was used to identify all adult patients who underwent adrenal metastasectomy from 2012 to 2022 at our institution. Site of primary disease, tumour size, surgical approach, and follow-up data were collected using electronic patients’ charts.

Results: Of 19 patients identified, primary sites include renal cancer (52%, n=10), colon cancer (31%, n=6), melanoma (10%, n=2) and lung cancer (5%, n=1). In 17 (89.5%) patients the adrenal was the only site of metastasis at the time of surgery. In terms of surgical approach, 13 cases (68%) were laparoscopic and 6 cases were open. The average follow-up was 25.4 months. No patients had a local recurrence and 60% developed recurrent metastasis. The average time to recurrence was 3 months (one patient was disease free at 28 months). Colorectal carcinoma recurrence rate is 100% in those followed and the average time to recurrence was 3.9 months. Renal cell carcinoma recurrence rate was 44.4% and the average time to recurrence was 1.6 months.

Conclusions: Our series shows that adrenal metastasectomy may not confer better oncological outcomes or reduce the likelihood of distant recurrence. Most of our patients had early disease progression despite adrenal metastasectomy.

Keywords: Adrenal glands; cancer; metastasectomy; metastasis; surgical procedures