Abstract:

Objective To evaluate the outcomes of surgical treatment for the patients with  non-small-cell lung cancer (NSCLC) complicated with isolated adrenal metastasis  with a systematic review and pooled analysis,and to provide an evidence for surgical treatment  of NSCLC   complicated  with isolated adrenal metastasis.Methods A search for publications on surgical treatment for NSCLC complicated with isolated adrenal metastasis from January 1990 to January 2013 was performed via the PubMed and ScienceDirect.The retrospective studies were expected to be included in pooled analysis.Results  11 studies including  87 patients who had received lung resection and adrenalectomy were selected.The mean survival time of the patients after operation was 41 months (95%CI,30.6－51.3 months)，and the median overall survival was 16 months (95%CI,9－23 months).The 1-year,2-year,and 5-year survival rates were 64.0%,37.7%,and 29.2%,respectively.In univariate analysis，the prognosis of the patients  with synchronous adrenal metastasis(SAM) was worse than those with metachronous adrenal metastasis(MAM),and  the median overall survival was 12 months   vs  31 months;the 1-year survival rates were 80.5%   and  46.8%,the 2-year survival rates were 52.3%   and  22.%,and the 5-year survival rates were 35.0%   and 22.5%.However,the pathology of primary lung cancer(squamous carcinoma and adenocarcinoma),the mediastinum lymph node or not and the position (ipsilateral or contralateral) of adrenal metastasis were not the prognostic factors.Conclusion Parts of the patients with NSCLC complicated with  isolated adrenal metastasis   after  lung resection  and adrenalectomy  have a long survival.The patients with MAM  have a better survival than the SAM patients.

Key words: carcinoma,non-small-cell lung, neoplasm metastasis, adrenalectomy