Pulmonary resection for metastatic adrenocortical carcinoma

The national cancer institute experience

Clinton D. Kemp, R. Taylor Ripley, Aarti Mathur, Seth M. Steinberg, Dao Nguyen, Tito Fojo, David S. Schrump

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Background: Adrenocortical carcinoma (ACC) is a rare neoplasm with a high propensity for locoregional recurrences and distant metastases for which there are no effective systemic therapies. This study was undertaken to determine outcomes of patients undergoing pulmonary metastasectomy for ACC. Methods: A single-institution retrospective review was performed of patients undergoing pulmonary metastasectomy for ACC from 1979 to 2010. Results: Twenty-six patients underwent 60 pulmonary metastasectomies. Fifteen patients (58%) underwent unilateral thoracotomy, 6 (23%) had staged thoracotomies, and 5 (19%) underwent median sternotomy as the initial thoracic procedure. Median number and size of lesions were 6 and 2 cm, respectively. Twenty-three patients (88%) were rendered free of disease in the lung, and 14 (54%) were rendered completely free of disease. Median overall and 5-year actuarial survivals from initial pulmonary metastasectomy were 40 months and 41%, respectively, with a median potential follow-up of 120 months. Median recurrence-free survival (RFS) and 5-year RFS for ipsilateral thoracic recurrences were 6 months, and 25%, respectively. The median RFS in the contralateral thorax was 5 months. Time to first recurrence after adrenalectomy and T stage of the primary tumor, but not adjuvant or neoadjuvant chemotherapy, were associated with increased overall survival after pulmonary metastasectomy. Conclusions: This study represents the most comprehensive review of outcomes of patients undergoing pulmonary metastasectomy for ACC. Given the lack of effective systemic therapies, pulmonary metastasectomy may be beneficial in properly selected patients.

Original languageEnglish
Pages (from-to)1195-1200
Number of pages6
JournalAnnals of Thoracic Surgery
Volume92
Issue number4
DOIs
StatePublished - Oct 1 2011
Externally publishedYes

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Metastasectomy
Adrenocortical Carcinoma
National Cancer Institute (U.S.)
Lung
Recurrence
Survival
Thorax
Thoracotomy
Sternotomy
Adrenalectomy
Lung Diseases
Neoplasms
Neoplasm Metastasis
Drug Therapy
Therapeutics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

Cite this

Pulmonary resection for metastatic adrenocortical carcinoma : The national cancer institute experience. / Kemp, Clinton D.; Ripley, R. Taylor; Mathur, Aarti; Steinberg, Seth M.; Nguyen, Dao; Fojo, Tito; Schrump, David S.

In: Annals of Thoracic Surgery, Vol. 92, No. 4, 01.10.2011, p. 1195-1200.

Research output: Contribution to journalArticle

Kemp, Clinton D. ; Ripley, R. Taylor ; Mathur, Aarti ; Steinberg, Seth M. ; Nguyen, Dao ; Fojo, Tito ; Schrump, David S. / Pulmonary resection for metastatic adrenocortical carcinoma : The national cancer institute experience. In: Annals of Thoracic Surgery. 2011 ; Vol. 92, No. 4. pp. 1195-1200.
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