How does adrenal gland involvement by renal cell carcinoma affect the prognosis, if any? Should a tumor directly infiltrating the ipsilateral adrenal gland be kept as a pT3a tumor?


There have been several reliable reports that recommended cases of adrenal involvement by renal cell carcinoma (RCC) by direct invasion be removed from the pT3a category and moved to pT4 because of their grave prognosis, which is comparable to that of pT4 carcinoma.


Renal Cell Carcinoma Adrenal Gland Adrenal Metastasis Direct Invasion AJCC Cancer Staging Manual 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Greene FL, Page DL, Fleming ID, Fritz A, Balch CM, Heller DG, Morrow M (2002) AJCC cancer staging manual. Springer-Verlag, New York, pp 323–328.CrossRefGoogle Scholar
  2. 2.
    Han KR, Bui MHT, Pantuck AJ, Freitas DG, Leibovich BC, Dorey FJ, Zisman A, Janzen NK, Mukouyama H, Figlin RA, Belldegrun AS (2003) TNM T3a renal cell carcinoma: adrenal gland involvement is not the same as renal fat invasion. J Urol 169:899–904.PubMedCrossRefGoogle Scholar
  3. 3.
    Sagalowsky AJ, Kadesky KT, Ewalt DM, Kennedy TJ (1994) Factors influencing adrenal metastasis in renal cell carcinoma. J Urol 151:1181–1184.PubMedGoogle Scholar
  4. 4.
    Sandock DS, Seftel AD, Resnick MI (1997) Adrenal metastases from renal cell carcinoma: role of ipsilateral adrenalectomy and definition of stage. Urology 49: 28–31.PubMedCrossRefGoogle Scholar
  5. 5.
    Thompson RH, Leibovich BC, Cheville JC, Lohse CM, Frank I, Kwon ED, Zincke H, Blute ML (2005) Should direct ipsilateral adrenal invasion from renal cell carcinoma be classified as pT3a? J Urol 173:918–921.PubMedCrossRefGoogle Scholar
  6. 6.
    Angervall L, Wahlqvist L (1978) Follow-up and prognosis of renal cell carcinoma in a series operated by perifascial nephrectomy combined with adrenalectomy and retroperitoneal lymphadenectomy. Eur Urol 4:13–17.PubMedGoogle Scholar
  7. 7.
    Kobayashi T, Nakamura E, Yamamoto S, Kamoto T, Okuno H, Terai A, Kakehi Y, Terachi T, Fujikawa K, Fukuzawa S, Takeuchi H, Ogawa O (2003) Low incidence of ipsilateral adrenal involvement and recurrences in patients with renal cell carcinoma undergoing radical nephrectomy: a retrospective analysis of 393 patients. Urology 62:40–45.PubMedCrossRefGoogle Scholar
  8. 8.
    Siemer S, Lehmann J, Loch L, Becker F, Stein U, Schneider G, Ziegler M, Stoeckle M (2005) Current TNM classification of renal cell carcinoma evaluated: revising stage T3a. J Urol 173:33–37.PubMedGoogle Scholar
  9. 9.
    Siemer S, Lehmann J, Kamradt J, Loch T, Remberger K, Humke U, Ziegler M, Stoeckle M (2004) Adrenal metastases in 1,635 patients with renal cell carcinoma: outcome and indication for adrenalectomy. J Urol 171: 2155–2159.PubMedCrossRefGoogle Scholar

Copyright information

© Springer 2008

Personalised recommendations