{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T04:16:47Z","timestamp":1785212207650,"version":"3.55.0"},"reference-count":30,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,2,13]],"date-time":"2024-02-13T00:00:00Z","timestamp":1707782400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Adrenalectomy is commonly considered a curative treatment in case of adrenal gland as site of metastasis. In the present study, we evaluated the impact of primary tumor histology on survival outcomes after a minimally invasive adrenal mastectomy for a solitary metachronous metastasis. From May 2004 to August 2020, we prospectively collected data on minimally invasive adrenalectomies whose pathological examination showed a metastasis. All patients only received metastasectomies that were performed with curative intent, or to achieve non-evidence of disease status. Adjuvant systemic therapy was not administered in any case. Cancer-specific survival (CSS) was assessed using the Kaplan\u2013Meier method. Univariable and multivariable Cox regression analyses were applied to identify independent predictors of CSS. Out of 235 laparoscopic and robotic adrenalectomies, the pathologic report showed metastases in 60 cases. The primary histologies included 36 (60%) renal cell carcinoma (RCC), 9 (15%) lung cancer, 6 (10%) colon cancer, 4 (6.7%) sarcoma, 3 (5%) melanoma and 2 (3.3%) bladder cancer. RCC displayed significantly longer survival rates with a 5-year CSS of 55.9%, versus 22.8% for other histologies (log-rank p = 0.01). At univariable analysis, disease-free interval (defined as the time from adrenalectomy to evidence of disease progression) &lt; 12 months and histology were predictors of CSS (p = 0.003 and p &lt; 0.001, respectively). At multivariable Cox analysis, the only independent predictor of CSS was primary tumor histology (p = 0.005); patients with adrenal metastasis from colon cancer and bladder cancer showed a 5.3- and 75.5-fold increased risk of cancer death, respectively, compared to patients who had RCC as primary tumor histology. Oncological outcomes of adrenal metastasectomies are strongly influenced by primary tumor histology. A proper discussion of the role of surgery in a multidisciplinary context could provide optimal treatment strategies.<\/jats:p>","DOI":"10.3390\/cancers16040763","type":"journal-article","created":{"date-parts":[[2024,2,13]],"date-time":"2024-02-13T04:09:21Z","timestamp":1707797361000},"page":"763","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Adrenalectomy for Metastasis: The Impact of Primary Histology on Survival Outcome"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5188-8001","authenticated-orcid":false,"given":"Mariaconsiglia","family":"Ferriero","sequence":"first","affiliation":[{"name":"Department of Urology, IRCCS \u201cRegina Elena\u201d National Cancer Institute, 00144 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2619-7465","authenticated-orcid":false,"given":"Andrea","family":"Iannuzzi","sequence":"additional","affiliation":[{"name":"Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfredo Maria","family":"Bove","sequence":"additional","affiliation":[{"name":"Department of Urology, IRCCS \u201cRegina Elena\u201d National Cancer Institute, 00144 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Tuderti","sequence":"additional","affiliation":[{"name":"Department of Urology, IRCCS \u201cRegina Elena\u201d National Cancer Institute, 00144 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umberto","family":"Anceschi","sequence":"additional","affiliation":[{"name":"Department of Urology, IRCCS \u201cRegina Elena\u201d National Cancer Institute, 00144 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo","family":"Misuraca","sequence":"additional","affiliation":[{"name":"Department of Urology, IRCCS \u201cRegina Elena\u201d National Cancer Institute, 00144 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aldo","family":"Brassetti","sequence":"additional","affiliation":[{"name":"Department of Urology, IRCCS \u201cRegina Elena\u201d National Cancer Institute, 00144 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3708-2209","authenticated-orcid":false,"given":"Riccardo","family":"Mastroianni","sequence":"additional","affiliation":[{"name":"Department of Urology, IRCCS \u201cRegina Elena\u201d National Cancer Institute, 00144 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Guaglianone","sequence":"additional","affiliation":[{"name":"Department of Urology, IRCCS \u201cRegina Elena\u201d National Cancer Institute, 00144 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Costantino","family":"Leonardo","sequence":"additional","affiliation":[{"name":"Department of Urology, IRCCS \u201cRegina Elena\u201d National Cancer Institute, 00144 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9566-7243","authenticated-orcid":false,"given":"Rocco","family":"Papalia","sequence":"additional","affiliation":[{"name":"Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Gallucci","sequence":"additional","affiliation":[{"name":"Department of Urology, IRCCS \u201cRegina Elena\u201d National Cancer Institute, 00144 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4868-9025","authenticated-orcid":false,"given":"Giuseppe","family":"Simone","sequence":"additional","affiliation":[{"name":"Department of Urology, IRCCS \u201cRegina Elena\u201d National Cancer Institute, 00144 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1177\/107327481101800206","article-title":"Management of Isolated Adrenal Lesions in Cancer Patients","volume":"18","author":"Mclean","year":"2011","journal-title":"Cancer Control"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2699","DOI":"10.21873\/anticanres.13395","article-title":"Metastatic Carcinomas of the Adrenal Glands: From Diagnosis to Treatment","volume":"39","author":"Spartalis","year":"2019","journal-title":"Anticancer Res."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4158\/EP.15.S1.1","article-title":"American Association of Clinical Endocrinologists and American Association of Endocrine Surgeons Medical Guidelines for The Management of Adrenal Incidentalomas","volume":"15","author":"Zeiger","year":"2009","journal-title":"Endocr. Pract."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1053\/j.tvir.2010.02.005","article-title":"Image-Guided Adrenal and Renal Biopsy","volume":"13","author":"Sharma","year":"2010","journal-title":"Tech. Vasc. Interv. Radiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1007\/s11934-009-0012-0","article-title":"Surgical Management of Metastases to the Adrenal Gland: Open, Laparoscopic, and Ablative Approaches","volume":"10","author":"Uberoi","year":"2009","journal-title":"Curr. Urol. Rep."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"zrac047","DOI":"10.1093\/bjsopen\/zrac047","article-title":"Outcome and Prognosis after Adrenal Metastasectomy: Nationwide Study","volume":"6","author":"Vlk","year":"2022","journal-title":"BJS Open"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"29","DOI":"10.5114\/wo.2020.93679","article-title":"Adrenal Metastases\u2014Long-Term Results of Surgical Treatment, Single-Centre Experience","volume":"24","author":"Samsel","year":"2020","journal-title":"Wsp\u00f3\u0142czesna Onkol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.1097\/SLA.0000000000003876","article-title":"Adrenalectomy for Secondary Malignancy: Patients, Outcomes, and Indications","volume":"274","author":"Wachtel","year":"2021","journal-title":"Ann. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1111\/iju.13580","article-title":"Purely Off-Clamp Robotic Partial Nephrectomy: Preliminary 3-Year Oncological and Functional Outcomes","volume":"25","author":"Simone","year":"2018","journal-title":"Int. J. Urol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1016\/j.eururo.2018.07.030","article-title":"Robot-Assisted Partial Adrenalectomy for the Treatment of Conn\u2019s Syndrome: Surgical Technique, and Perioperative and Functional Outcomes","volume":"75","author":"Simone","year":"2019","journal-title":"Eur. Urol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1159\/000167843","article-title":"Laparoscopic Transperitoneal Right Adrenalectomy for \u2018Large\u2019 Tumors","volume":"81","author":"Papalia","year":"2008","journal-title":"Urol. Int."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"20170520","DOI":"10.1259\/bjr.20170520","article-title":"Diagnostic Accuracy of 18 F-FDG PET or PET\/CT for the Characterization of Adrenal Masses: A Systematic Review and Meta-Analysis","volume":"91","author":"Kim","year":"2018","journal-title":"Br. J. Radiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1097\/MNM.0000000000000757","article-title":"The Utility of 18F-FDG PET\/CT for the Diagnosis of Adrenal Metastasis in Lung Cancer","volume":"38","author":"Wu","year":"2017","journal-title":"Nucl. Med. Commun."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"201","DOI":"10.3389\/fonc.2016.00201","article-title":"The Place of FDG PET\/CT in Renal Cell Carcinoma: Value and Limitations","volume":"6","author":"Liu","year":"2016","journal-title":"Front. Oncol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1016\/j.clgc.2022.03.010","article-title":"Benefit of Metastasectomy in Renal Cell Carcinoma: A Propensity Score Analysis","volume":"20","author":"Maisel","year":"2022","journal-title":"Clin. Genitourin. Cancer"},{"key":"ref_16","first-page":"77.e17","article-title":"Prognostic Impact of Metastasectomy in Renal Cell Carcinoma in the Postcytokine Therapy Era","volume":"39","author":"Ishihara","year":"2021","journal-title":"Urol. Oncol. Semin. Orig. Investig."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Ferriero, M., Cacciatore, L., Ochoa, M., Mastroianni, R., Tuderti, G., Costantini, M., Anceschi, U., Misuraca, L., Brassetti, A., and Guaglianone, S. (2023). The Impact of Metastasectomy on Survival Outcomes of Renal Cell Carcinoma: A 10-Year Single Center Experience. Cancers, 15.","DOI":"10.3390\/cancers15133332"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/j.eururo.2022.03.006","article-title":"European Association of Urology Guidelines on Renal Cell Carcinoma: The 2022 Update","volume":"82","author":"Ljungberg","year":"2022","journal-title":"Eur. Urol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1869","DOI":"10.1007\/s11255-020-02496-w","article-title":"Prognostic Factors after Adrenalectomy for Adrenal Metastasis","volume":"52","author":"Goujon","year":"2020","journal-title":"Int. Urol. Nephrol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.ijsu.2015.10.038","article-title":"Patient Selection for Laparoscopic Excision of Adrenal Metastases: A Multicenter Cohort Study","volume":"24","author":"Gryn","year":"2015","journal-title":"Int. J. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2571","DOI":"10.1245\/s10434-021-11192-7","article-title":"Survival After Adrenalectomy for Metastatic Lung Cancer","volume":"29","author":"Krumeich","year":"2022","journal-title":"Ann. Surg. Oncol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1336","DOI":"10.1007\/s00268-014-2454-x","article-title":"Adrenal Metastectomy Is Safe in Selected Patients","volume":"38","author":"Sui","year":"2014","journal-title":"World J. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1016\/j.amjsurg.2007.12.018","article-title":"Melanoma Adrenal Metastasis: Natural History and Surgical Management","volume":"195","author":"Mittendorf","year":"2008","journal-title":"Am. J. Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1002\/jso.27267","article-title":"Melanoma Metastatic to the Adrenal Gland: An Update on the Role of Adrenalectomy in Multidisciplinary Management","volume":"128","author":"Asare","year":"2023","journal-title":"J. Surg. Oncol."},{"key":"ref_25","first-page":"362","article-title":"Robotic Adrenalectomy for Sigmoid Colon Cancer Oligometastasis","volume":"3","author":"Pai","year":"2015","journal-title":"Ann. Transl. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1111\/iju.14288","article-title":"Predictors of Use and Overall Survival for Patients Undergoing Metastasectomy for Bladder Cancer in a National Cohort","volume":"27","author":"Weiner","year":"2020","journal-title":"Int. J. Urol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1224","DOI":"10.1016\/j.surg.2021.12.003","article-title":"Robot-Assisted versus Conventional Laparoscopic Adrenalectomy: Results from the EUROCRINE Surgical Registry","volume":"171","author":"Vatansever","year":"2022","journal-title":"Surgery"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.ijrobp.2020.01.017","article-title":"Stereotactic Body Radiation Therapy of Adrenal Metastases: A Pooled Meta-Analysis and Systematic Review of 39 Studies with 1006 Patients","volume":"107","author":"Chen","year":"2020","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"20170607","DOI":"10.1259\/bjr.20170607","article-title":"Effectiveness and Safety of CT-Guided Percutaneous Radiofrequency Ablation of Adrenal Metastases","volume":"91","author":"Zhou","year":"2018","journal-title":"Br. J. Radiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1148\/radiol.2015142029","article-title":"Unresectable Adrenal Metastases: Clinical Outcomes of Radiofrequency Ablation","volume":"277","author":"Hasegawa","year":"2015","journal-title":"Radiology"}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/16\/4\/763\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T13:59:07Z","timestamp":1760104747000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/16\/4\/763"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,13]]},"references-count":30,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,2]]}},"alternative-id":["cancers16040763"],"URL":"https:\/\/doi.org\/10.3390\/cancers16040763","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,13]]}}}