Adrenal Tumors Found During Staging and Surveillance for Colorectal Cancer: Benign Incidentalomas or Metastatic Disease?
Objective To evaluate the incidence of adrenal metastases in patient with colorectal cancer (CRC) and determine the clinical and radiographic features associated metastatic CRC to the adrenal glands. Materials and Methods The review of consecutive adults with newly diagnosed CRC found to have adrena...
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| Veröffentlicht in: | World journal of surgery 2020-07, Vol.44 (7), p.2282-2287 |
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| creator | Yanagisawa, Mio Malik, Dania G. Loehfelm, Thomas W. Fananapazir, Ghaneh Corwin, Michael T. Campbell, Michael J. |
| description | Objective
To evaluate the incidence of adrenal metastases in patient with colorectal cancer (CRC) and determine the clinical and radiographic features associated metastatic CRC to the adrenal glands.
Materials and Methods
The review of consecutive adults with newly diagnosed CRC found to have adrenal tumors > 1 cm in size on staging or surveillance CT scans with at least two scans to evaluate progression or stability of disease.
Results
Fifty-eight of 856 (6.8%) CRC patients had an adrenal tumor. Forty-three patients (74%) with 46 adrenal tumors had benign adrenal tumors, and 15 (26%) patients with 17 adrenal tumors had metastatic disease. On univariate analysis, patients with metastatic CRC had larger adrenal tumors (26.7 mm vs 12.4 mm,
p
2.5 ng/mL (OR 15.8 CI 1.7–144) and other metastatic disease seen on imaging (OR 68.1 CI 7–661) were independently associated with adrenal metastases.
Conclusion
CRC patients with small adrenal tumors, normal CEA levels and no evidence of other metastatic disease are unlikely to have spread to the adrenal glands. Adrenal tumors found during staging and surveillance of CRC patients should be evaluated with appropriate imaging and biochemical analysis. |
| doi_str_mv | 10.1007/s00268-020-05479-1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2382662243</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2382662243</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4266-5586465ff1483cad1f9a4c9364ff1e2ae19e687539bb3fb2678e08b1549290cb3</originalsourceid><addsrcrecordid>eNqNkU1v1DAQhi0EotvCH-CALHHhEhh_xHF6Qe2WhaIiDlvE0XKcySpVEi920o9_j0MKlThUnMYaP-_rGb-EvGLwjgEU7yMAVzoDDhnksigz9oSsmBQ844KLp2QFQsl0ZuKAHMZ4BcAKBeo5ORCcg9J5sSK3J3XAwXb0cup9iHTjp6GmZ1Nohx3djnY3V5ta2ylcY9t1dnBIGx_o2nc-oBuTdj03wzE9xaHdDfR8cG2NQ7rxvY00sV9xtHG0Y-voWRvRRvzwgjxrbBfx5X09It83Hy_Xn7OLb5_O1ycXmZNcqSzPtZIqbxomtXC2Zk1ppSvTYqmF3CIrUekiF2VViabiqtAIumK5LHkJrhJH5O3iuw_-54RxNH0bHc6LoJ-i4UKndziXIqFv_kGv_BTS5yRKgi5EzhUkii-UCz7GgI3Zh7a34c4wMHMuZsnFpFzM71wMS6LX99ZT1WP9V_IniAQcL8BN2-Hdf1iaH1-2pxsAWaokFos47ufcMDwM_shMvwBx36jh</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2408735260</pqid></control><display><type>article</type><title>Adrenal Tumors Found During Staging and Surveillance for Colorectal Cancer: Benign Incidentalomas or Metastatic Disease?</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>SpringerLink Journals - AutoHoldings</source><creator>Yanagisawa, Mio ; Malik, Dania G. ; Loehfelm, Thomas W. ; Fananapazir, Ghaneh ; Corwin, Michael T. ; Campbell, Michael J.</creator><creatorcontrib>Yanagisawa, Mio ; Malik, Dania G. ; Loehfelm, Thomas W. ; Fananapazir, Ghaneh ; Corwin, Michael T. ; Campbell, Michael J.</creatorcontrib><description>Objective
To evaluate the incidence of adrenal metastases in patient with colorectal cancer (CRC) and determine the clinical and radiographic features associated metastatic CRC to the adrenal glands.
Materials and Methods
The review of consecutive adults with newly diagnosed CRC found to have adrenal tumors > 1 cm in size on staging or surveillance CT scans with at least two scans to evaluate progression or stability of disease.
Results
Fifty-eight of 856 (6.8%) CRC patients had an adrenal tumor. Forty-three patients (74%) with 46 adrenal tumors had benign adrenal tumors, and 15 (26%) patients with 17 adrenal tumors had metastatic disease. On univariate analysis, patients with metastatic CRC had larger adrenal tumors (26.7 mm vs 12.4 mm,
p
< 0.01), a higher mean CEA (239 ng/mL vs 14.2 ng/mL,
p
= 0.03), and were more likely to have other sites of metastatic disease seen on imaging 8/43 (19%) vs 14/15 (93%),
p
< 0.01. On multivariable analysis, adrenal tumor size > 1.8 cm (OR 49.6 CI 8–306), CEA > 2.5 ng/mL (OR 15.8 CI 1.7–144) and other metastatic disease seen on imaging (OR 68.1 CI 7–661) were independently associated with adrenal metastases.
Conclusion
CRC patients with small adrenal tumors, normal CEA levels and no evidence of other metastatic disease are unlikely to have spread to the adrenal glands. Adrenal tumors found during staging and surveillance of CRC patients should be evaluated with appropriate imaging and biochemical analysis.</description><identifier>ISSN: 0364-2313</identifier><identifier>EISSN: 1432-2323</identifier><identifier>DOI: 10.1007/s00268-020-05479-1</identifier><identifier>PMID: 32206857</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Abdominal Surgery ; Adrenal Gland Neoplasms - diagnostic imaging ; Adrenal Gland Neoplasms - epidemiology ; Adrenal Gland Neoplasms - secondary ; Adrenal glands ; Adult ; Aged ; Biochemical analysis ; Cancer ; Cardiac Surgery ; Colorectal cancer ; Colorectal carcinoma ; Colorectal Neoplasms - diagnostic imaging ; Colorectal Neoplasms - pathology ; Computed tomography ; Diagnosis, Differential ; Female ; Follow-Up Studies ; General Surgery ; Humans ; Incidence ; Incidental Findings ; Male ; Medical imaging ; Medicine ; Medicine & Public Health ; Metastases ; Metastasis ; Middle Aged ; Neoplasm Staging ; Neoplasms, Second Primary - diagnostic imaging ; Neoplasms, Second Primary - epidemiology ; Original Scientific Report ; Retrospective Studies ; Stability analysis ; Surgery ; Surveillance ; Thoracic Surgery ; Tomography, X-Ray Computed ; Tumors ; Vascular Surgery</subject><ispartof>World journal of surgery, 2020-07, Vol.44 (7), p.2282-2287</ispartof><rights>Société Internationale de Chirurgie 2020</rights><rights>2020 The Author(s) under exclusive licence to Société Internationale de Chirurgie</rights><rights>Société Internationale de Chirurgie 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4266-5586465ff1483cad1f9a4c9364ff1e2ae19e687539bb3fb2678e08b1549290cb3</citedby><cites>FETCH-LOGICAL-c4266-5586465ff1483cad1f9a4c9364ff1e2ae19e687539bb3fb2678e08b1549290cb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00268-020-05479-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00268-020-05479-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,41467,42536,45553,45554,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32206857$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yanagisawa, Mio</creatorcontrib><creatorcontrib>Malik, Dania G.</creatorcontrib><creatorcontrib>Loehfelm, Thomas W.</creatorcontrib><creatorcontrib>Fananapazir, Ghaneh</creatorcontrib><creatorcontrib>Corwin, Michael T.</creatorcontrib><creatorcontrib>Campbell, Michael J.</creatorcontrib><title>Adrenal Tumors Found During Staging and Surveillance for Colorectal Cancer: Benign Incidentalomas or Metastatic Disease?</title><title>World journal of surgery</title><addtitle>World J Surg</addtitle><addtitle>World J Surg</addtitle><description>Objective
To evaluate the incidence of adrenal metastases in patient with colorectal cancer (CRC) and determine the clinical and radiographic features associated metastatic CRC to the adrenal glands.
Materials and Methods
The review of consecutive adults with newly diagnosed CRC found to have adrenal tumors > 1 cm in size on staging or surveillance CT scans with at least two scans to evaluate progression or stability of disease.
Results
Fifty-eight of 856 (6.8%) CRC patients had an adrenal tumor. Forty-three patients (74%) with 46 adrenal tumors had benign adrenal tumors, and 15 (26%) patients with 17 adrenal tumors had metastatic disease. On univariate analysis, patients with metastatic CRC had larger adrenal tumors (26.7 mm vs 12.4 mm,
p
< 0.01), a higher mean CEA (239 ng/mL vs 14.2 ng/mL,
p
= 0.03), and were more likely to have other sites of metastatic disease seen on imaging 8/43 (19%) vs 14/15 (93%),
p
< 0.01. On multivariable analysis, adrenal tumor size > 1.8 cm (OR 49.6 CI 8–306), CEA > 2.5 ng/mL (OR 15.8 CI 1.7–144) and other metastatic disease seen on imaging (OR 68.1 CI 7–661) were independently associated with adrenal metastases.
Conclusion
CRC patients with small adrenal tumors, normal CEA levels and no evidence of other metastatic disease are unlikely to have spread to the adrenal glands. Adrenal tumors found during staging and surveillance of CRC patients should be evaluated with appropriate imaging and biochemical analysis.</description><subject>Abdominal Surgery</subject><subject>Adrenal Gland Neoplasms - diagnostic imaging</subject><subject>Adrenal Gland Neoplasms - epidemiology</subject><subject>Adrenal Gland Neoplasms - secondary</subject><subject>Adrenal glands</subject><subject>Adult</subject><subject>Aged</subject><subject>Biochemical analysis</subject><subject>Cancer</subject><subject>Cardiac Surgery</subject><subject>Colorectal cancer</subject><subject>Colorectal carcinoma</subject><subject>Colorectal Neoplasms - diagnostic imaging</subject><subject>Colorectal Neoplasms - pathology</subject><subject>Computed tomography</subject><subject>Diagnosis, Differential</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>General Surgery</subject><subject>Humans</subject><subject>Incidence</subject><subject>Incidental Findings</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>Neoplasm Staging</subject><subject>Neoplasms, Second Primary - diagnostic imaging</subject><subject>Neoplasms, Second Primary - epidemiology</subject><subject>Original Scientific Report</subject><subject>Retrospective Studies</subject><subject>Stability analysis</subject><subject>Surgery</subject><subject>Surveillance</subject><subject>Thoracic Surgery</subject><subject>Tomography, X-Ray Computed</subject><subject>Tumors</subject><subject>Vascular Surgery</subject><issn>0364-2313</issn><issn>1432-2323</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqNkU1v1DAQhi0EotvCH-CALHHhEhh_xHF6Qe2WhaIiDlvE0XKcySpVEi920o9_j0MKlThUnMYaP-_rGb-EvGLwjgEU7yMAVzoDDhnksigz9oSsmBQ844KLp2QFQsl0ZuKAHMZ4BcAKBeo5ORCcg9J5sSK3J3XAwXb0cup9iHTjp6GmZ1Nohx3djnY3V5ta2ylcY9t1dnBIGx_o2nc-oBuTdj03wzE9xaHdDfR8cG2NQ7rxvY00sV9xtHG0Y-voWRvRRvzwgjxrbBfx5X09It83Hy_Xn7OLb5_O1ycXmZNcqSzPtZIqbxomtXC2Zk1ppSvTYqmF3CIrUekiF2VViabiqtAIumK5LHkJrhJH5O3iuw_-54RxNH0bHc6LoJ-i4UKndziXIqFv_kGv_BTS5yRKgi5EzhUkii-UCz7GgI3Zh7a34c4wMHMuZsnFpFzM71wMS6LX99ZT1WP9V_IniAQcL8BN2-Hdf1iaH1-2pxsAWaokFos47ufcMDwM_shMvwBx36jh</recordid><startdate>202007</startdate><enddate>202007</enddate><creator>Yanagisawa, Mio</creator><creator>Malik, Dania G.</creator><creator>Loehfelm, Thomas W.</creator><creator>Fananapazir, Ghaneh</creator><creator>Corwin, Michael T.</creator><creator>Campbell, Michael J.</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>202007</creationdate><title>Adrenal Tumors Found During Staging and Surveillance for Colorectal Cancer: Benign Incidentalomas or Metastatic Disease?</title><author>Yanagisawa, Mio ; Malik, Dania G. ; Loehfelm, Thomas W. ; Fananapazir, Ghaneh ; Corwin, Michael T. ; Campbell, Michael J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4266-5586465ff1483cad1f9a4c9364ff1e2ae19e687539bb3fb2678e08b1549290cb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Abdominal Surgery</topic><topic>Adrenal Gland Neoplasms - diagnostic imaging</topic><topic>Adrenal Gland Neoplasms - epidemiology</topic><topic>Adrenal Gland Neoplasms - secondary</topic><topic>Adrenal glands</topic><topic>Adult</topic><topic>Aged</topic><topic>Biochemical analysis</topic><topic>Cancer</topic><topic>Cardiac Surgery</topic><topic>Colorectal cancer</topic><topic>Colorectal carcinoma</topic><topic>Colorectal Neoplasms - diagnostic imaging</topic><topic>Colorectal Neoplasms - pathology</topic><topic>Computed tomography</topic><topic>Diagnosis, Differential</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>General Surgery</topic><topic>Humans</topic><topic>Incidence</topic><topic>Incidental Findings</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metastases</topic><topic>Metastasis</topic><topic>Middle Aged</topic><topic>Neoplasm Staging</topic><topic>Neoplasms, Second Primary - diagnostic imaging</topic><topic>Neoplasms, Second Primary - epidemiology</topic><topic>Original Scientific Report</topic><topic>Retrospective Studies</topic><topic>Stability analysis</topic><topic>Surgery</topic><topic>Surveillance</topic><topic>Thoracic Surgery</topic><topic>Tomography, X-Ray Computed</topic><topic>Tumors</topic><topic>Vascular Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yanagisawa, Mio</creatorcontrib><creatorcontrib>Malik, Dania G.</creatorcontrib><creatorcontrib>Loehfelm, Thomas W.</creatorcontrib><creatorcontrib>Fananapazir, Ghaneh</creatorcontrib><creatorcontrib>Corwin, Michael T.</creatorcontrib><creatorcontrib>Campbell, Michael J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>World journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yanagisawa, Mio</au><au>Malik, Dania G.</au><au>Loehfelm, Thomas W.</au><au>Fananapazir, Ghaneh</au><au>Corwin, Michael T.</au><au>Campbell, Michael J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Adrenal Tumors Found During Staging and Surveillance for Colorectal Cancer: Benign Incidentalomas or Metastatic Disease?</atitle><jtitle>World journal of surgery</jtitle><stitle>World J Surg</stitle><addtitle>World J Surg</addtitle><date>2020-07</date><risdate>2020</risdate><volume>44</volume><issue>7</issue><spage>2282</spage><epage>2287</epage><pages>2282-2287</pages><issn>0364-2313</issn><eissn>1432-2323</eissn><abstract>Objective
To evaluate the incidence of adrenal metastases in patient with colorectal cancer (CRC) and determine the clinical and radiographic features associated metastatic CRC to the adrenal glands.
Materials and Methods
The review of consecutive adults with newly diagnosed CRC found to have adrenal tumors > 1 cm in size on staging or surveillance CT scans with at least two scans to evaluate progression or stability of disease.
Results
Fifty-eight of 856 (6.8%) CRC patients had an adrenal tumor. Forty-three patients (74%) with 46 adrenal tumors had benign adrenal tumors, and 15 (26%) patients with 17 adrenal tumors had metastatic disease. On univariate analysis, patients with metastatic CRC had larger adrenal tumors (26.7 mm vs 12.4 mm,
p
< 0.01), a higher mean CEA (239 ng/mL vs 14.2 ng/mL,
p
= 0.03), and were more likely to have other sites of metastatic disease seen on imaging 8/43 (19%) vs 14/15 (93%),
p
< 0.01. On multivariable analysis, adrenal tumor size > 1.8 cm (OR 49.6 CI 8–306), CEA > 2.5 ng/mL (OR 15.8 CI 1.7–144) and other metastatic disease seen on imaging (OR 68.1 CI 7–661) were independently associated with adrenal metastases.
Conclusion
CRC patients with small adrenal tumors, normal CEA levels and no evidence of other metastatic disease are unlikely to have spread to the adrenal glands. Adrenal tumors found during staging and surveillance of CRC patients should be evaluated with appropriate imaging and biochemical analysis.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>32206857</pmid><doi>10.1007/s00268-020-05479-1</doi><tpages>6</tpages></addata></record> |
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| subjects | Abdominal Surgery Adrenal Gland Neoplasms - diagnostic imaging Adrenal Gland Neoplasms - epidemiology Adrenal Gland Neoplasms - secondary Adrenal glands Adult Aged Biochemical analysis Cancer Cardiac Surgery Colorectal cancer Colorectal carcinoma Colorectal Neoplasms - diagnostic imaging Colorectal Neoplasms - pathology Computed tomography Diagnosis, Differential Female Follow-Up Studies General Surgery Humans Incidence Incidental Findings Male Medical imaging Medicine Medicine & Public Health Metastases Metastasis Middle Aged Neoplasm Staging Neoplasms, Second Primary - diagnostic imaging Neoplasms, Second Primary - epidemiology Original Scientific Report Retrospective Studies Stability analysis Surgery Surveillance Thoracic Surgery Tomography, X-Ray Computed Tumors Vascular Surgery |
| title | Adrenal Tumors Found During Staging and Surveillance for Colorectal Cancer: Benign Incidentalomas or Metastatic Disease? |
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