Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
3
pubmed:dateCreated
2003-4-2
pubmed:abstractText
Since in the absence of clinically overt metastatic disease tumorous lesions within the adrenal gland are found in only 2-10% of cases, the majority of renal cell cancer patients are overtreated by adrenalectomy as an integral part of nephrectomy. The medical records of 847 patients undergoing adrenalectomy in combination with nephrectomy irrespective of the local extent of the primary tumor or the clinical stage at first diagnosis were reviewed to determine the reliability of currently available imaging modalities regarding the prediction of adrenal gland metastases. Several patient and tumor characteristics correlated with the presence of intra-adrenal metastases, and their prognostic value was determined by a multivariate logistic regression model. Metastatic spread into the adrenal gland was observed in 27 of 847 (3%) patients. In only three of eight patients in whom the adrenal was identified as the only metastatic site, preoperative abdominal CT scans were interpreted as false negative. During multivariate statistical analysis, only the presence of distant metastases, vascular invasion within the primary tumor, and multifocal growth of renal cell cancer within the tumor-bearing kidney were identified to independently predict the likelihood for the presence of intra-adrenal metastases. None of the patient or tumor characteristics evaluated reliably predicted the likelihood for the presence of adrenal metastases in patients without evidence of disseminated metastatic spread. As we believe and as the current investigation demonstrates, routine adrenalectomy should not be recommended in cases of preoperatively normal radiological examinations.
pubmed:language
ger
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:month
Mar
pubmed:issn
0340-2592
pubmed:author
pubmed:issnType
Print
pubmed:volume
42
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
366-73
pubmed:dateRevised
2006-11-15
pubmed:meshHeading
pubmed-meshheading:12671770-Adrenal Gland Neoplasms, pubmed-meshheading:12671770-Adrenal Glands, pubmed-meshheading:12671770-Adrenalectomy, pubmed-meshheading:12671770-Carcinoma, Renal Cell, pubmed-meshheading:12671770-Female, pubmed-meshheading:12671770-Germany, pubmed-meshheading:12671770-Humans, pubmed-meshheading:12671770-Kidney, pubmed-meshheading:12671770-Kidney Neoplasms, pubmed-meshheading:12671770-Logistic Models, pubmed-meshheading:12671770-Male, pubmed-meshheading:12671770-Multivariate Analysis, pubmed-meshheading:12671770-Neoplasm Invasiveness, pubmed-meshheading:12671770-Neoplasm Staging, pubmed-meshheading:12671770-Nephrectomy, pubmed-meshheading:12671770-Predictive Value of Tests, pubmed-meshheading:12671770-Retrospective Studies, pubmed-meshheading:12671770-Tomography, X-Ray Computed, pubmed-meshheading:12671770-Unnecessary Procedures
pubmed:year
2003
pubmed:articleTitle
[Is adrenalectomy an indispensable part of nephrectomy? Results of a multivariate statistical analysis].
pubmed:affiliation
Klinik für Urologie, Medizinische Hochschule Hannover. kuczyk.markus@mh-hannover.de
pubmed:publicationType
Journal Article, English Abstract, Evaluation Studies