肝腫瘤合併腎上腺轉移之治療與預後回顧性分析-台中榮民總醫院經驗

邱俊凱、陳卷書¹

台中榮民總醫院 外科部 泌尿科；¹台中榮民總醫院醫院 外科部 泌尿科

Retrospective analysis of Hepatocellular carcinoma with adrenal metastasis treatment and prognosis – VGTCH experience

Chiou JK1, Chen JS 2,

1Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan,2 Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan,

Purpose:

Adrenal metastasis of hepatocellular carcinoma is rare and had yet no clear treatment guideline for it. Recently had some research point out more aggressive local intervention are not inferior to systemic treatment. We use our VGTCH data base for analysis.

Materials and Methods:

We retrospectively collect a total 252 HCC patient’s with extrahepatic metastasis and only 8 was confirmed of adrenal metastasis(6 unilateral, 2 bilateral). We analyze patient character, time of HCC diagnosed and time to adrenal metastasis. 5 years survival rates and complications rates.

Results:

All the patient was around 60 to 80 years old. Male was more then female (6 vs. 2). 7 out of 8 patients received hepatectomy when first diagnosed of HCC, only one received TAE prior to hepatectomy. Initial adrenal metastasis was found in 2 patients. Others had diagnosed of adrenal metastasis from firstly diagnosed of HCC in 5 months to 39 months. 2 patients died in 1 year(severe GI bleeding and peritoneal severe seeding). Other 6 patient had 100% of 5 year survival despite of other extrahepatic metastasis such as lung metastasis. All patient had no surgical related compliations to open adrenalectomy or laparoscopic adrenalectomy.

Conclusions:

 To our VGTCH experience, metastasis adrenalectomy despite of open, laparoscopic or robotic method, it is a safe procedure with low complication rates which leads to acceptable survival rates and prognosis. Our data supported previous research of more aggressive local treatment if the primary tumor is under controlled and the patient had adequate physical condition.