Adrenalectomy for metastases from hepatocellular carcinoma - a single center experience
Autor: | Irinel Popescu, Sorin Alexandrescu, Mirela Boros, Doina Hrehoret, Adina Croitoru, Vlad Brasoveanu, Vlad Herlea, Eliza Gangone, Silviu Ciurea |
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Rok vydání: | 2006 |
Předmět: |
Male
medicine.medical_specialty Carcinoma Hepatocellular medicine.medical_treatment Adrenal Gland Neoplasms Single Center Metastasis Medicine Hepatectomy Humans Aged business.industry Adrenalectomy General surgery Liver Neoplasms Vascular surgery Middle Aged medicine.disease digestive system diseases Cardiac surgery Cardiothoracic surgery Hepatocellular carcinoma Surgery Radiology business Abdominal surgery |
Zdroj: | Langenbeck's archives of surgery. 392(3) |
ISSN: | 1435-2443 |
Popis: | Adrenal metastases (AM) from hepatocellular carcinoma (HCC) are rarely seen in clinical practice. The treatment is not standardized, the indications and efficacy of different therapeutic approaches being still controversial.Between January 1995 and December 2005, 174 patients underwent liver resection for HCC in our center. AM were detected in four patients (2.3%): three of them had HCC and synchronous AM, and the remaining one developed AM 10 months after liver resection. All the patients with AM were treated by adrenalectomy (simultaneously with liver resection in synchronous metastases), followed by systemic chemotherapy. Non-resectable multifocal liver recurrences occurred in two patients, one of them having also a contralateral adrenal metastasis; these two patients are presently alive 26 and 43 months after adrenalectomy, respectively. Another patient died by liver recurrence 27 months postoperatively. The fourth patient is disease-free at 17 months after the initial operation.Adrenalectomy for AM from HCC should be performed whenever the primary tumor is well therapeutically controlled and the patient has a good performance status. Adrenalectomy offers the chance of more than 2 years survival in many patients. However, once AM are detected, the prognosis remains poor. |
Databáze: | OpenAIRE |
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