Outcomes Of Surgical Treatment For Isolated Adrenal Metastasis In Non-small Cell Lung Cancer: A Systematic Review And Pooled Analysis

Objective To evaluate the outcomes of surgical treatment forisolated adrenal metastasis in non–small cell lung cancer with asystematic review and pooled analysis, and provide an evidence ofsurgical treatment for NSCLC with isolated adrenal metastasis.Methods：A search for publications on surgical treatment for non-smallcell lung cancer with isolated adrenal metastasis from January1990toJanuary2013was performed via the PubMed and Sciencedirect.Retrospective studies were expected to be included in pooled analysis.Results：There were11studies contributing87patients who hadreceived lung resection and adrenalectomy. The mean survival time was41months (95%CI:30.6-51.3months)，and the median overall survivalwas16months (95%CI:9-23months). The1-year,2-year and5-yearsurvival rate was64.0%,37.7%and29.2%respectively. In univariateanalysis，the prognosis of patients with synchronous metastasis was worse than those with metachronous metastasis (median overall survivalwas12months vs31months,1-year survival rate was80.5%vs46.8%,2-year survival rate was52.3%vs22.%,5-year survival rate was35.0%vs22.5%). However, the pathology of primary lung cancer, the stage ofmediastinum lymph node and the position (ipsilateral or contralateral) ofadrenal metastasis were not prognostic factors.Conclusion：For an isolated adrenal metastasis from NSCLC, part ofthe patients undergoing surgical treatment for both primary lung cancerand isolated adrenal metastasis have a long survival. Patients withadrenal metachronous metastasis predict a better survival.