PURPOSE: Ipsilateral adrenalectomy is usually performed during radical nephrectomy because of @entity1358 . Because @entity703 are detected more often in the earlier stages due to widespread use of ultrasound and computerized tomography, we define a subset of @entity1 who would be eligible for adrenal sparing surgery. In a retrospective analysis we evaluated whether parameters obtained preoperatively are able to predict adrenal metastasis. MATERIALS AND METHODS: A total of 866 consecutive @entity1 who underwent nephrectomy and ipsilateral adrenalectomy from 1983 to 1999 were evaluated. Preoperative parameters, including @entity5 size, location, clinical stage, number of @entity5 , and @entity1 age and sex, were retrospectively compared with the histological results. Univariate and multivariate analyses were performed. RESULTS: A total of 27 (3.1%) adrenal @entity3 were noted in the 866 @entity1 , and 63% were on the left side and 37% on the right side. Mean @entity5 size was 10 cm. with versus 6 cm. without adrenal involvement. Of the 27 @entity1 21 had multiple @entity3 at diagnosis and only 6 (0.7% of all 866) presented with solitary ipsilateral adrenal metastasis. Univariate and multivariate analyses revealed @entity5 size and M stage as best preoperative predictors of adrenal involvement. CONCLUSIONS: Adrenal sparing surgery is possible, and we suggest a new algorithm. If maximum @entity5 size measured by computerized tomography is less than 8 cm. and staging examination does not show organ or lymph node @entity3 , adrenalectomy is not necessary because of oncological reasons. This algorithm has to be validated by a prospective analysis.

Adrenal sparing surgery during radical nephrectomy in @entity1 with XXXX : a new algorithm.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'tumors'] @entity1358 :: ('MESH:D002292', 'Disease') :: ['renal cell cancer'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastases'] @entity703 :: ('MESH:D007680', 'Disease') :: ['renal tumors']
@entity1358 :: (MESH:D002292,Disease) :: ['renal cell cancer']
