Ito K et al. - Tumor size >5.5 cm, clinical T stage of ≥3, LNM, and DM outside IAd are important preoperative indicators of ipsilateral adrenal involvement (IADI). Moreover, patients with renal cell carcinoma (RCC) who have normal adrenal, a T1 tumor extending <5.5 cm, and have neither lymph node metastasis (LNM) nor distant metastasis (DM) are good candidates for adrenal-sparing nephrectomy. Methods
A retrospectively review of pts treated for RCC to clarify the risk factors for IADI
Clinicopathologic factors of 30 pts with IADI were compared with 926 control pts w/o IADI
Independent predictors for IADI were identified by multivariate analysis
Results
Preoperative CT scan could detect 83.3% of synchronous ipsilateral adrenal metastasis
Pts with IADI had larger primary tumors, higher pT stages and histologic grades, and higher percentages of upper pole involvement, microvascular invasion, spindle-cell-type tumors, LNM and DM outside the IAd vs control pts
Tumor size >5.5 cm, pT stage ≥3, LNM, and DM outside IAd, but not upper pole involvement, were significant predictors of IADI
