Adrenal Metastases in Lung Cancer Clinical Implications of a Mathematical Model

作者:Bazhenova Lyudmila*; Newton Paul; Mason Jeremy; Bethel Kelly; Nieva Jorge; Kuhn Peter
来源:Journal of Thoracic Oncology, 2014, 9(4): 442-446.
DOI:10.1097/JTO.0000000000000133

摘要

Adrenal gland metastases are common in lung cancer. It is well recognized that aggressive treatment of solitary adrenal metastases leads to improved outcomes but the exact nature of adrenal deposits is not well understood. Controversy exists as to the routing of cancer cells to the adrenal gland with some believing that this transmission is lymphatic, in contrast to the more generally accepted theory of hematogenous spread. Recently published mathematical modeling of cancer progression strongly supports the lymphatic theory. With that in mind, we performed a literature review to look for biological plausibility of simulation results and believe that evidence supports the contention that metastases to the adrenal gland can be routed by means of lymphatic channels. This could explain improved survival for patients in whom solitary adrenal metastases are managed aggressively with surgical or radiation modalities. We are calling for clinical trials prospectively testing this hypothesis.

  • 出版日期2014-4