Ipsilateral Adrenalectomy During RN Hikes Death Risk

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ATLANTA—Ipsilateral adrenalectomy at the time of radical nephrectomy (RN) is associated with decreased survival, according to research presented at the American Urological Association 2012 annual meeting.

Stanley A. Yap, MD, of the University of Toronto, and colleagues conducted a population-level analysis based in Ontario, Canada from 1995 to 2004 of 1,651 patients undergoing RN for T1a renal tumors. The overall rate of ipsilateral adrenalectomy at the time of RN was 30%. The cohort had a median follow-up of 9.1 years.

Adrenal gland removal was associated with worse overall survival, with a 10-year mortality rate of 26%. In multivariate analysis, ipsilateral adrenalectomy was associated with a 23% increased risk of death. It was not associated with cancer-specific survival. Patients were identified through the Ontario Cancer Registry (OCR) and individual data was linked with pathologic data from abstracted pathology reports to determine whether or not ipsilateral adrenal gland was removed at time of RN.

“Our findings further support the importance of adrenal-sparing approaches at the time of RN,” the authors concluded.

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