Work

Survival outcomes and prognostic predictors after adrenalectomy for renal cell carcinoma adrenal metastasis

Year: 2025

Type: article

Abstract: PURPOSE: To evaluate survival outcomes after adrenalectomy for renal cell carcinoma (RCC) adrenal metastasis and to identify risk factors influencing overall survival. METHODS: We retrospectively reviewed all histologically confirmed cases of RCC adrenal metastasis managed at a tertiary center from January 2013 to December 2024. Overall survival (OS) was estimated with Kaplan-Meier analysis and compared with log-rank tests. Prognostic factors were examined using univariable and multivariable Cox proportional hazards models. RESULTS: A total of 82 patients with RCC adrenal metastasis were included (median age 60.5 years; IQR 54.8-67.0). Metachronous disease was present in 52 patients (63.4%), and 8 (9.8%) had bilateral adrenal involvement. Seventy-one patients (86.6%) underwent adrenalectomy; seven with bilateral primary renal tumors were excluded owing to indeterminate timing and/or laterality, leaving 64 for survival analysis. After a median follow-up of 32.5 months (IQR 14.8-80.8), the 1-, 3-, and 5-year OS rates were 96.6% (95% CI 92.2-100.0%), 87.1% (95% CI 77.8-97.6%), and 74.4% (95% CI 61.4-90.2%), respectively. Log-rank analysis showed poorer OS for synchronous presentation (P = 0.02), RCC T3/4 stage (P < 0.001), and primary tumor diameter > 6 cm (P = 0.001). In multivariable Cox analysis, increasing primary tumor diameter was the only independent predictor of reduced OS (HR 1.33, 95% CI 1.02-1.75; P = 0.04). CONCLUSIONS: Adrenalectomy provides durable survival for well-selected patients with isolated or oligometastatic RCC adrenal metastasis. Prospective multicenter trials comparing surgery with non-surgical modalities are needed to refine management algorithms.

Source: Discover Oncology

DOI: 10.1007/s12672-025-04160-0