Adrenal sparing surgery for renal cell carcinoma.

Abstract:

OBJECTIVE:To investigate the feasibility of adrenal sparing surgery for selected renal cell carcinoma (RCC), since the necessity of routine adrenalectomy during radical nephrectomy for RCC has been challenged in recent years. METHODS:178 patients underwent perifascial nephrectomy in a 16-year period. Of these patients, 96 had ipsilateral adrenal gland preserved during nephrectomy and 82 underwent concomitant adrenalectomy. 75 excised adrenal specimens were examined pathologically. Disease specific survival rates were assessed according to the pathological stage of the tumors. RESULTS:Of the 75 patients, 53 presented a macroscopically normal adrenal gland without pathohistological changes. The other 22 patients were suspected to have adrenal metastasis intraoperatively, while only 5 of them were confirmed to have adrenal involvement by histopathology. Two patients in the adrenal gland preservation group developed ipsilateral adrenal recurrence and synchronous or metachronous contralateral adrenal metastasis during follow-up, although both were documented to have a normal-appearing adrenal gland intraoperatively. Five patients with adrenal metastasis and 2 patients with adrenal recurrence had large renal tumors. The survival difference among subgroups of patients undergoing adrenalectomy or with adrenal gland left in situ was not statistically significant. CONCLUSION:Adrenal sparing surgery could be done for patients with small renal tumors along with macroscopically normal ipsilateral adrenal glands.

journal_name

Chin Med J (Engl)

journal_title

Chinese medical journal

authors

Xu C,Niu Z,Lü J,Wang J

keywords:

subject

Has Abstract

pub_date

1998-10-01 00:00:00

pages

877-80

issue

10

eissn

0366-6999

issn

2542-5641

journal_volume

111

pub_type

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