• Agathe Rémond, Camille Marciniak, Xavier Lenne, Vincent Chouraki, Mathilde Gobert, Gregory Baud, Laure Maillard, Damien Bouriez, Ellen Liekens, Gianluca Donatini, Claire Nominé-Criqui, Ambroise Ravenet, Nicolas Santucci, Paulina Kuczma, Nicolas Bouviez, Christophe Tresallet, Eric Mirallié, Sophie Deguelte, Laurent Brunaud, Carole Guerin, Caroline Gronnier, Jean-Christophe Lifante, Amélie Bruandet, Didier Theis, Alexis Cortot, Arnaud Scherpereel, Aghiles Hamroun, François Pattou, and Robert Caiazzo.
• General Endocrine Surgery, Lille University Hospital Chu Lille, Egid-Umr 1190, Translational Research Laboratory For Diabetes, Lille University, - Lille (France).
• Ann. Surg. 2024 Aug 7.

ObjectiveTo provide a nationwide description of postoperative outcomes and analysis of prognostic factors following adrenalectomy for metastases.Summary Background DataAdrenal glands are a common site of metastases in many malignancies. Diagnosisof adrenal metastases is on the rise, leading to an increasing number of patient candidates for surgery without consensual management.MethodsWe conducted a population-based study between January 2012 and December 2022 using the French national health data system (SNDS) and the Eurocrine® registry (NCT03410394). The first database exhaustively covers all procedures carried out in France, while the second provides more clinical information on procedures and tumor characteristics, based on the experience of 11 specialized centers.ResultsFrom the SNDS, we extracted 2,515 patients who underwent adrenalectomy for secondary malignancy and 307 from the Eurocrine® database. The most common primary malignancies were lung cancer (n=1,203, 47.8%) and renal cancer (n=555, 22.1%). One-year survival was 84.3% (n=2,120). Thirty-day mortality and morbidity rates were, respectively, 1.3% (n=32) and 29.9% (n=753, including planned ICU stays). Radiotherapy within the year before adrenalectomy was significantly associated with higher 30-day major complication rates (P=0.039). In the Eurocrine® database, the proportion of laparoscopic procedures reached 85.3% without impairing resection completeness (R0: 92.9%). Factors associated with poor overall survival were presence of extra-adrenal metastases (HR=0.64; P=0.031) and incomplete resection (≥R1; HR=0.41; P=0.015).ConclusionThe number of patients who can receive local treatment for adrenal metastases is rising, and adrenalectomy is more often minimally invasive and has a low morbidity rate. Subsequent research should evaluate which patients would benefit from adrenal surgery.Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

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