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Clin Lung Cancer. 2019 Nov;20(6):405-411. doi: 10.1016/j.cllc.2019.06.003. Epub 2019 Jun 13.

Clinical Characteristics, Molecular Phenotyping, and Management of Isolated Adrenal Metastases From Lung Cancer.

Author information

1
Thoracic Surgery Department, Paris Center University Hospital, Assistance Publique - Hôpitaux de Paris, Paris Descartes University, Paris, France.
2
Radiotherapy Department, Hopital Tenon, AP-HP, Paris, France.
3
Pathology Department, Paris Center University Hospital, Assistance Publique - Hôpitaux de Paris, Paris Descartes University, Paris, France.
4
Pharmacogenetics and Molecular Oncology Unit, Paris Center University Hospital, Assistance Publique - Hôpitaux de Paris, Paris Descartes University, Paris, France.
5
Thoracic Surgery Department, Paris Center University Hospital, Assistance Publique - Hôpitaux de Paris, Paris Descartes University, Paris, France. Electronic address: marco.alifano@aphp.fr.

Abstract

INTRODUCTION:

Adrenal gland metastases occur in up to 20% of patients with non-small-lung cancer. In selected cases with limited burden of disease, surgery may be offered to improve patient outcome; furthermore, tissue analysis would provide useful information on genotype of primary and secondary neoplasms.

MATERIALS AND METHODS:

We report our experience in the management of adrenal metastasis by retrospectively reviewing data of 21 consecutive patients treated with curative intent to the primary tumor followed by adrenalectomy in a 15-year time span. Targeted next generation sequencing was performed to compare molecular profile of primary lung cancers and adrenal metastases. Patient overall survival was assessed by Kaplan-Meier method, using adrenalectomy as time zero. Survival rates were compared by log rank test.

RESULTS:

No surgery-related mortality or morbidity was observed. Median survival was 50 months; 5-year overall survival was 34.5% (95% confidence interval, 12%-66%). No significant survival difference was observed with respect to timing of onset (synchronous vs. metachronous) or side (homolateral vs. contralateral) of adrenal metastasis, T or N status of primary lung cancer, mutational asset, and histologic type. Mutations in TP53 genes were found in 61% and 85% of primary and metastatic tumors, respectively. In 3 of 15 cases, we found differences between molecular mutation patterns in primary lung cancer and corresponding adrenal metastasis.

CONCLUSIONS:

Adrenalectomy is a safe and effective approach in selected cases. Discordance between primary and secondary tumor mutational profile was found in 20% of assessable patients.

KEYWORDS:

Ablative therapy; NSCLC; Oligo-metastatic disease; Radiotherapy; Surgery

PMID:
31281051
DOI:
10.1016/j.cllc.2019.06.003
[Indexed for MEDLINE]

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