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Long-Term Survival After Complete Resection of Melanoma Metastatic to the Adrenal Gland

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Abstract

Background: Survival of patients with American Joint Committee on Cancer stage IV melanoma is generally poor, although there are occasional long-term survivors who have undergone surgical resection of a limited number of metastases. In the study, we examined the outcome of patients with adrenal gland metastases.

Methods: Eighty-three patients with adrenal metastases were identified from our computerized melanoma database of 8250 patients. Univariate and multivariate analyses for overall survival differences were performed by using proportional hazards modeling.

Results: Median survival for the 83 patients was 9.3 months (1–67 months). Of the 27 patients who underwent surgical exploration, 18 (66%) were rendered clinically free of disease by adrenalectomy alone (12 cases) or by adrenalectomy and resection of additional disease (6 cases). Nine patients underwent palliative adrenal resection. Median survival was 25.7 months after complete resection compared with 9.2 months after palliative resection (P = .02). Conclusions: Patients with adrenal metastases from melanoma, either isolated or with a limited number of additional metastases, may benefit from surgical resection if all visible disease can be removed. Patients with unresectable extra-adrenal disease achieve no survival benefit from adrenalectomy.

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REFERENCES

  1. Overett TK, Shiu MH. Surgical treatment of distant metastatic melanoma: indications and results. Cancer 1985;56:1222–1230.

    CAS  PubMed  Google Scholar 

  2. Feun LG, Gutterman J, Burgess MA, et al. The natural history of resectable metastatic melanoma (stage IVA melanoma). Cancer 1982;50:1656–1663.

    CAS  PubMed  Google Scholar 

  3. Wong JH, Skinner KA, Kim KA, Foshag LJ, Morton DL. The role of Surgery in the treatment of nonregionally recurrent melanoma. Surgery 1993;113:389–394.

    CAS  PubMed  Google Scholar 

  4. Karakousis CP, Moore R, Holyoke ED. Surgery in recurrent malignant melanoma. Cancer 1983;52:1342–1345.

    CAS  PubMed  Google Scholar 

  5. Day CL, Lew RA. Malignant melanoma prognostic factors 6: distant metastases and length of survival. J Dermatol Surg Oncol 1984;10:686–689.

    PubMed  Google Scholar 

  6. Lejeune FJ, Lienard D, Sales F, Badr-el-Din H. Surgical management of distant melanoma metastases. Semin Surg Oncol 1992;8:381–391.

    CAS  PubMed  Google Scholar 

  7. Wornom IL, Soong S-J, Urist MM, Smith JW, McElvein R, Balch CM. Surgery as palliative treatment for distant metastases of melanoma. Ann Surg 1986;204:181–5.

    PubMed  Google Scholar 

  8. Ollila DW, Essner R, Wanek LA, Morton DL. Surgical resection for melanoma metastatic to the gastrointestinal tract. Arch Surg 1996;131:975–980.

    CAS  PubMed  Google Scholar 

  9. Tafra L, Dale PS, Wanek LA, Ramming KP, Morton DL. Resection and adjuvant immunotherapy for melanoma metastatic to the lung and thorax. J Thorac Cardiovasc Surg 1995;110:119–129.

    CAS  PubMed  Google Scholar 

  10. Branum GD, Seigler HF. Role of surgical intervention in the management of intestinal metastases from malignant melanoma. Am J Surg 1991;162:428–431.

    CAS  PubMed  Google Scholar 

  11. Gorenstein LA, Putnam JB, Natarajan G, Balch CA, Roth JA. Improved survival after resection of pulmonary metastases from malignant melanoma. Ann Thorac Surg 1991;52:204–210.

    Article  CAS  PubMed  Google Scholar 

  12. Klaase JM, Kroon BBR. Surgery for melanoma metastatic to the gastrointestinal tract. Br J Surg 1990;77:60–61.

    CAS  PubMed  Google Scholar 

  13. Branum GD, Epstein RE, Leight GS, Seigler HF. The role of resection in the management of melanoma metastatic to the adrenal gland. Surgery 1991;109:127–131.

    CAS  PubMed  Google Scholar 

  14. Lo CY, van Heerden JA, Soreide JA, et al. Adrenalectomy for metastatic disease to the adrenal glands. Br J Surg 1996;83:528–531.

    CAS  PubMed  Google Scholar 

  15. Kim SH, Brennan MF, Russo P, Burt ME, Coit DG. The role of surgery in the treatment of clinically isolated adrenal metastasis. Cancer 1998;82:389–394.

    CAS  PubMed  Google Scholar 

  16. Wade TP, Longo WE, Virgo KS, Johnson FE. A comparison of adrenalectomy with other resections for metastatic cancers. Am J Surg 1998;175:183–186.

    CAS  PubMed  Google Scholar 

  17. Patel JK, Didolkar MS, Pickren JW, Moore RH. Metastatic pattern of malignant melanoma. Am J Surg 1978;135:807–810.

    CAS  PubMed  Google Scholar 

  18. Kaplan EL, Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc 1958;53:457–481.

    Google Scholar 

  19. Higashiyama M, Doi O, Kodama K, Yokouchi H, Imaoka S, Koyama H. Surgical treatment of adrenal metastasis following pulmonary resection for lung cancer: comparison of adrenalectomy with palliative therapy. Int J Surg 1994;79:124–129.

    CAS  Google Scholar 

  20. Luketich JD, Burt ME. Does resection of adrenal metastases from NSCLC improve survival? Ann Thorac Surg 1996;62:1614–1616.

    CAS  PubMed  Google Scholar 

  21. Soffen EM, Solin LJ, Rubenstein JH, Hanks GE. Palliative radiotherapy for symptomatic adrenal metastases. Cancer 1990;65:1318–1320.

    CAS  PubMed  Google Scholar 

  22. Barth A, Wanek LA, Morton DL. Prognostic factors in 1521 melanoma patients with distant metastases. J Am Coll Surg 1995;181:193–201.

    CAS  PubMed  Google Scholar 

  23. Hena MA, Emrich LJ, Nambisan RN, Karakousis CP. Effect of surgical treatment on stage IV melanoma. Am J Surg 1987;153: 270–275.

    CAS  PubMed  Google Scholar 

  24. Morton DL, Foshag LJ, Hoon DSB, et al. Prolongation of survival in metastatic melanoma after active specific immunotherapy with a new polyvalent melanoma vaccine. Ann Surg 1992;216:463–482.

    CAS  PubMed  Google Scholar 

  25. Morton DL, Nizze A, Hoon DSB, et al. Improved survival of advanced stage IV melanoma following active immunotherapy: correlation with immune response to melanoma vaccine [Abstract]. Proc Am Soc Clin Oncol 1993;12:391.

    Google Scholar 

  26. Hsueh EC, Nizze A, Essner R, Foshag L, Famatiga E, Stern SL, Morton DL. Adjuvant immunotherapy with polyvalent melanoma cell vaccine (PMCV) prolongs survival after complete resection of distant melanoma metastases [Abstract]. Proc Am Soc Clin Oncol 1997;16:492.

    Google Scholar 

  27. Gagner M, Pomp A, Heniford BT, Pharand D, Lacroix A. Laparoscopic adrenalectomy: lessons learned from 100 consecutive procedures. Ann Surg 1997;226:238–247.

    Article  CAS  PubMed  Google Scholar 

  28. Linos DA, Stylopoulos N, Boukis M, Souvatzoglou A, Raptis S, Papadimitrou J. Anterior, posterior, or laparoscopic approach for the management of adrenal diseases? Am J Surg 1997;173:120–125.

    CAS  PubMed  Google Scholar 

  29. Suzuki K, Ushiyama T, Mugiya S, Kageyama S, Saisu K, Fujita K. Hazards of laparoscopic adrenalectomy in patients with adrenal malignancy. J Urol 1997;158:2227.

    CAS  PubMed  Google Scholar 

  30. Elashry OM, Clayman RV, Soble JJ, McDougall EM. Laparoscopic adrenalectomy for solitary metachronous contralateral adrenal metastasis from renal cell carcinoma. J Urol 1997;157:1217–1222.

    CAS  PubMed  Google Scholar 

  31. Winfield HN, Hamilton BD, Bravo EL. Technique of laparoscopic adrenalectomy. Urol Clin North Am 1997;24:459–465.

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Roy E. Coats Research Laboratories and the Division of Surgical Oncology, John Wayne Cancer Institute, 2200 Santa Monica Blvd., Santa Monica, CA, 90404

    Philip I. Haigh MD, FRCSC, Richard Essner MD, James C. Wardlaw MD, Stacey L. Stern MS & Donald L. Morton MD

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  1. Philip I. Haigh MD, FRCSC
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  2. Richard Essner MD
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  3. James C. Wardlaw MD
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  4. Stacey L. Stern MS
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  5. Donald L. Morton MD
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Haigh, P.I., Essner, R., Wardlaw, J.C. et al. Long-Term Survival After Complete Resection of Melanoma Metastatic to the Adrenal Gland. Ann Surg Oncol 6, 633–639 (1999). https://doi.org/10.1007/s10434-999-0633-z

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  • DOI: https://doi.org/10.1007/s10434-999-0633-z

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