The Journal of Urology
Volume 181, Issue 6 , Pages 2430-2437 , June 2009

Management of the Adrenal Gland During Partial Nephrectomy

  • Brian R. Lane

      Affiliations

    • Corresponding Author InformationCorrespondence and requests for reprints: Glickman Urological Institute, The Cleveland Clinic Foundation, 9500 Euclid Ave., A100, Cleveland, Ohio 44195 (telephone: 216-445-7242; FAX: 216-445-2267)
    • Recipient of a Research Scholar grant from the American Urological Association Foundation.
    • ,
  • Ho-Yee Tiong

      Affiliations

    • Nothing to disclose.
    • ,
  • Steven C. Campbell

      Affiliations

    • Financial interest and/or other relationship with Novartis, Pfizer and Sanofi Aventis.
    • ,
  • Amr F. Fergany

      Affiliations

    • Nothing to disclose.
    • ,
  • Christopher J. Weight

      Affiliations

    • Nothing to disclose.
    • ,
  • Benjamin T. Larson

      Affiliations

    • Nothing to disclose.
    • ,
  • Andrew C. Novick

      Affiliations

    • Nothing to disclose.
    • ,
  • Stuart M. Flechner

      Affiliations

    • Financial interest and/or other relationship with Novartis Pharmaceuticals, Wyeth Pharmaceuticals, Roche Pharmaceuticals, Genzyme Pharmaceuticals, Tc Land and Clinical Transplantation.

Received 17 October 2008

References 

  1. Robson CJ, Churchill BM, Anderson W. The results of radical nephrectomy for renal cell carcinoma. J Urol. 1969;101:297
  2. Gopan T, Remer E, Hamrahian AH. Evaluating and managing adrenal incidentalomas. Cleve Clin J Med. 2006;73:561
  3. Shalev M, Cipolla B, Guille F, Staerman F, Lobel B. Is ipsilateral adrenalectomy a necessary component of radical nephrectomy?. J Urol. 1995;153:1415
  4. Li GR, Soulie M, Escourrou G, Plante P, Pontonnier F. Micrometastatic adrenal invasion by renal carcinoma in patients undergoing nephrectomy. Br J Urol. 1996;78:826
  5. Sandock DS, Seftel AD, Resnick MI. Adrenal metastases from renal cell carcinoma: role of ipsilateral adrenalectomy and definition of stage. Urology. 1997;49:28
  6. von Knobloch R, Seseke F, Riedmiller H, Grone HJ, Walthers EM, Kalble T. Radical nephrectomy for renal cell carcinoma: is adrenalectomy necessary?. Eur Urol. 1999;36:303
  7. Paul R, Mordhorst J, Busch R, Leyh H, Hartung R. Adrenal sparing surgery during radical nephrectomy in patients with renal cell cancer: a new algorithm. J Urol. 2001;166:59
  8. Siemer S, Lehmann J, Kamradt J, Loch T, Remberger K, Humke U, et al. Adrenal metastases in 1635 patients with renal cell carcinoma: outcome and indication for adrenalectomy. J Urol. 2004;171:2155
  9. Antonelli A, Cozzoli A, Simeone C, Zani D, Zanotelli T, Portesi E, et al. Surgical treatment of adrenal metastasis from renal cell carcinoma: a single-centre experience of 45 patients. BJU Int. 2006;97:505
  10. Matveev VB, Baronin AA. Kidney cancer metastasis to the adrenal gland (Role of adrenalectomy). Urologiia. 2002;3:11
  11. Sagalowsky AI, Kadesky KT, Ewalt DM, Kennedy TJ. Factors influencing adrenal metastasis in renal cell carcinoma. J Urol. 1994;151:1181
  12. Wunderlich H, Schlichter A, Reichelt O, Zermann DH, Janitzky V, Kosmehl H, et al. Real indications for adrenalectomy in renal cell carcinoma. Eur Urol. 1999;35:272
  13. Ito A, Satoh M, Ohyama C, Saito S, Shintaku I, Nakano O, et al. Adrenal metastasis from renal cell carcinoma: significance of adrenalectomy. Int J Urol. 2002;9:125
  14. Kuczyk M, Munch T, Machtens S, Bokemeyer C, Wefer A, Hartmann J, et al. The need for routine adrenalectomy during surgical treatment for renal cell cancer: the Hannover experience. BJU Int. 2002;89:517
  15. Yokoyama H, Tanaka M. Incidence of adrenal involvement and assessing adrenal function in patients with renal cell carcinoma: is ipsilateral adrenalectomy indispensable during radical nephrectomy?. BJU Int. 2005;95:526
  16. Lee CT, Katz J, Shi W, Thaler HT, Reuter VE, Russo P. Surgical management of renal tumors 4 cm. or less in a contemporary cohort. J Urol. 2000;163:730
  17. Lau WK, Blute ML, Weaver AL, Torres VE, Zincke H. Matched comparison of radical nephrectomy vs nephron-sparing surgery in patients with unilateral renal cell carcinoma and a normal contralateral kidney. Mayo Clin Proc. 2000;75:1236
  18. McKiernan J, Simmons R, Katz J, Russo P. Natural history of chronic renal insufficiency after partial and radical nephrectomy. Urology. 2002;59:816
  19. Thompson RH, Boorjian SA, Lohse CM, Leibovich BC, Kwon ED, Cheville JC, et al. Radical nephrectomy for pT1a renal masses may be associated with decreased overall survival compared with partial nephrectomy. J Urol. 2008;179:468
  20. Miller DC, Hollingsworth JM, Hafez KS, Daignault S, Hollenbeck BK. Partial nephrectomy for small renal masses: an emerging quality of care concern?. J Urol. 2006;175:853
  21. Winter P, Miersch WD, Vogel J, Jaeger N. On the necessity of adrenal extirpation combined with radical nephrectomy. J Urol. 1990;144:842
  22. Alamdari FI, Ljungberg B. Adrenal metastasis in renal cell carcinoma: a recommendation for adjustment of the TNM staging system. Scand J Urol Nephrol. 2005;39:277
  23. Huisman TK, Sands JP. Renal cell carcinoma with solitary metachronous contralateral adrenal metastasis (Experience with 2 cases and review of the literature). Urology. 1991;38:364
  24. Dieckmann KP, Wullbrand A, Krolzig G. Contralateral adrenal metastasis in renal cell cancer. Scand J Urol Nephrol. 1996;30:139
  25. Kessler OJ, Mukamel E, Weinstein R, Gayer E, Konichezky M, Servadio C. Metachronous renal cell carcinoma metastasis to the contralateral adrenal gland. Urology. 1998;51:539
  26. Sagalowsky AI, Molberg K. Solitary metastasis of renal cell carcinoma to the contralateral adrenal gland 22 years after nephrectomy. Urology. 1999;54:162
  27. Lau WK, Zincke H, Lohse CM, Cheville JC, Weaver AL, Blute ML. Contralateral adrenal metastasis of renal cell carcinoma: treatment, outcome and a review. BJU Int. 2003;91:775
  28. Featherstone JM, Bass P, Cumming J, Smart CJ. Solitary, late metastatic recurrence of renal cell carcinoma: two extraordinary cases. Int J Urol. 2006;13:1525
  29. Antonelli A, Zani D, Cozzoli A, Cunico SC. Surgical treatment of metastases from renal cell carcinoma. Arch Ital Urol Androl. 2005;77:125
  30. Paul R, Mordhorst J, Leyh H, Hartung R. Incidence and outcome of patients with adrenal metastases of renal cell cancer. Urology. 2001;57:878
  31. Kuczyk M, Wegener G, Jonas U. The therapeutic value of adrenalectomy in case of solitary metastatic spread originating from primary renal cell cancer. Eur Urol. 2005;48:252
  32. Nagesser SK, van Seters AP, Kievit J, Hermans J, Krans HM, van de Velde CJ. Long-term results of total adrenalectomy for Cushing's disease. World J Surg. 2000;24:108
  33. Kristan JL. Addisonian crisis precipitated by nephrectomy. J Urol. 1949;61:178
  34. Goldenberg SL, Wright JE, McLoughlin MG. Metastatic renal cell carcinoma: unusual cause of Addison disease. Urology. 1983;22:408

 Study received institutional review board approval.

 Editor's Note: This article is the second of 5 published in this issue for which category 1 CME credits can be earned. Instructions for obtaining credits are given with the questions on pages 2834 and 2835.

PII: S0022-5347(09)00355-3

doi: 10.1016/j.juro.2009.02.027

The Journal of Urology
Volume 181, Issue 6 , Pages 2430-2437 , June 2009

Article Tools

* Image Usage & Resolution