Risk Factors for Adrenal Invasion in Renal Cell Carcinoma.

Objective: In this study, we aimed to describe the risk factors associated with adrenal invasion in patients who were diagnosed with renal cell carcinoma (RCC) after radical nephrectomy and identify which risk factors are indications for ipsilateral adrenalectomy (IA). Materials and Methods: Preoperative (age, gender, tumor side and location, presence of lung metastasis), intraoperative (thrombectomy rate, IA and additional surgery rate), and histopathological data of 298 patients with RCC were reviewed. The patients were divided into 2 groups, those with adrenal invasion and those without, and patient data were compared between these groups. Subsequently, rates of renal sinus invasion, perinephric invasion, and renal vein invasion were evaluated in the T3-4 and T3a patient group and the relationship between these rates and adrenal invasion was investigated. Results: Adrenal invasion was detected in 8 (2.7%) of the patients. There were no significant relationships between adrenal invasion and age, gender, tumor side, tumor location, surgery duration, thrombectomy rate, disease stage, sarcomatoid features, microvascular invasion, collecting system invasion, tumor necrosis, or renal vein invasion. The presence of adrenal invasion was associated with a higher rate of additional intraoperative interventions. Adrenal invasion was also significantly associated with greater tumor size, higher pathologic T (pT) stage, and rates of lung metastasis, perinephric invasion, and renal sinus invasion. When stage pT3-4 and pT3a patients were evaluated separately, no significant relation was found between adrenal invasion and renal sinus invasion, perinephric invasion, or renal venous invasion. Conclusion: pT stage, presence of pulmonary metastasis, and renal sinus invasion were important risk factors for adrenal invasion. [ABSTRACT FROM AUTHOR]