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[The indications for adrenalectomy in the surgical treatment of renal-cell cancer].

To clarify the frequency of involvement of the collateral adrenal in patients with renal cell carcinoma (RCC) and to formulate indications to adrenalectomy in performing radical nephrectomy, the author assessed treatment results in 130 RCC patients (73 males and 57 females, mean age 52.6 +/- 0.3 years). 36 subjects had T2N0M0, 48--T3N0M0, 46--T4N0M0. Preoperatively, all the patients were divided into prognostic groups. Irrespective of the prognosis, 102 patients underwent radical nephrectomy. 18 patients with uncertain prognosis and 10 patients with good prognosis were subjected to nephrectomy without adrenalectomy. Metastases to the collateral adrenal were detected in 16.1%, 2.5% and 0% of patients with poor prognosis, uncertain and good prognosis, respectively. 5-year survival in groups with poor, uncertain and good prognosis was 28.6, 50 and 93.7%, respectively; in patients with uncertain prognosis after radical nephrectomy or nephrectomy without adrenalectomy it was 47.5 and 55.5%, respectively; with good prognosis--100 and 90%, respectively. In bad prognosis, the adrenal must be removed because of high metastatic risk. In RCC patients with uncertain or good prognosis in the absence of preoperative evidence on adrenal tumor adrenalectomy performed with nephrectomy does not improve 5-year treatment outcomes.