Adjuvant radiotherapy for the primary treatment of adrenocortical carcinoma: are we offering the best?

Srougi, Victor; Bessa, José de; Tanno, Fabio Y; Ferreira, Amanda Pifano Soares; Hoff, Ana O.; Bezerra, Joao E.; Almeida, Carla; Almeida, Madson Q.; Mendonca, Berenice B.; Nahas, William C.; Chambô, José Luis; Srougi, Miguel; Fragoso, Maria Candida Barisson Villares

doi:10.1590/s1677-5538.ibju.2017.0095

Cited by 21 publications

(21 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The majority of patients was treated with conformal three-dimensional RT with only two patients reported to treated with conventional RT in the Germany study [9]. Two included studies did not describe the details on treatment technique, target volume, or treatment machine [10,12]. It was difficult to observe a relation between the LRFS rate with RT dose or RT…”

Section: Discussionmentioning

confidence: 99%

“…2), and 11 of them were subsequently excluded with reasons give. The remaining 5 studies and our data were selected for our analysis (Table 2) [9][10][11][12][13]. A total of 238 participants were selected for the meta-analysis, of which 111 and 127 patients underwent ART after surgical resection and only surgical resection, respectively.…”

Section: Meta-analysis For Oncological Outcomesmentioning

confidence: 99%

See 1 more Smart Citation

Efficacy of adjuvant radiotherapy for treatment of adrenocortical carcinoma: a retrospective study and an updated meta-analysis

Zhu

Zheng

Shen

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Adrenocortical carcinoma (ACC) is a rare and highly aggressive malignancy. Surgical resection is the standard treatment for localized ACC, but the local recurrence remains high. Adjuvant radiation (ART) has been proposed as a means to reduce recurrence rates in ACC after surgery with conflicting results from nonrandomized studies. We performed a retrospective study and a meta-analysis to determine the impact of ART on survival outcomes.Methods: A retrospective study of the adrenocortical cancer database in Peking Union Medical College was conducted. We selected postoperative ACC patients with or without ART. A meta-analysis is also performed to compare the outcomes between ART and only surgical resection in ACC patients. The obtained data were analyzed using SPSS 23.0 and Stata 15.0 statistical software. Differences between two groups were compared using the log-rank test for retrospective analysis and estimated by calculating the odds ratio (OR) and 95% confidence interval (CI) for meta-analysis.Results: Of a total of 75 patients available in the database, 12 patients underwent postoperative ART and were matched one to one to patients with only surgical resection. There was no significant difference on overall survival between ART group and control group (log-rank P = 0.149). Locoregional recurrence was diagnosed in 2 of the ART group, and in 4 of the control group (P=0.64). A total of 238 participants were selected for the meta-analysis, of which 111 and 127 patients underwent ART after surgical resection and only surgical resection, respectively. Overall survival is significantly higher in ART group, with an odds ratio (OR) of 2.41 (95% CI of 1.33, 4.38; P = 0.004). Besides, meta-analysis significantly favored ART for locoregional recurrence-free survival and disease-free survival, with an OR of 4.08 and 2.27, respectively. Conclusions: Our results show that compared to only surgical resection, ART is an effective postoperative treatment for ACC.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Meta-analysis For Oncological Outcomesmentioning

confidence: 99%

Efficacy of adjuvant radiotherapy for treatment of adrenocortical carcinoma: a retrospective study and an updated meta-analysis

Zhu

Zheng

Shen

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Some indicated adjuvant radiotherapy may prolong the time to ACC local recurrence [35,36] , some even thought adjuvant therapy was associated with decreased recurrence [24] , others suggested it was of bene t in stage IV disease [32,37] . However, there was a consensus that it was no bene t for OS [24,35,38] . In our study, patients receiving adjuvant therapy didn't have signi cantly improved OS.…”

Section: Discussionmentioning

confidence: 99%

Summary of clinical characteristics of common primary adrenal malignancies in adults

zhang¹,

wang²,

Li³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background To summary the clinical characteristics of common primary adrenal malignancies in adults, the survival time of the patients, and the prognostic factors associated with these rare malignancies. Methods The Surveillance, Epidemiology, and End Results database (1975–2016) was queried for all patients who were diagnosed with primary adrenal malignancies, including adrenocortical carcinoma(ACC), pheochromocytoma and paraganglioma (PPGL), lymphoma, and sarcoma (SA). The clinical characteristics, overall survival (OS) and cancer-specific survival (CSS) were analyzed, in which propensity score methodology, logistic regression modeling and Kaplan-Meier survival curves were used. The Multivariate Cox proportional hazard model was used to identify factors affecting the prognosis of patients with ACC. Results 3204 patients with primary adrenal malignancies were identified, including 2180 with ACC, 593 with PPGL, 307 with lymphoma, and 124 with SA. Generally, PPGL had a better prognosis than others. For ACC and PPGL, the non-metastatic group had better OS and CSS than the metastatic group; for SA, the non-metastatic group had better OS, however, there was no significant difference in CSS between the two groups. Furthermore, For ACC, the single metastasis group had a better OS than the multiple metastasis group. After tumors metastasis, the surgery group, surgery of primary adrenal lesions, had better OS and CSS than the non-surgery group for ACC and PPGL. For lymphoma, the chemotherapy group had better OS and CSS; for ACC and PPGL, the chemotherapy group had better CSS and worse OS; for SA, the survival showed no significant difference between the two groups. Radiotherapy had the same effect on patients' survival as chemotherapy, except for the lymphoma and the ACC. As for lymphoma, the radiotherapy group had better CSS, whereas the survival showed no significant difference in OS between the two groups. For ACC, the non- radiotherapy group had better CSS and OS. More importantly, for lymphoma, under the condition that both cohorts were the same basically, the surgical group had a better prognosis. The prognosis of ACC was related to sex, age, seer historic stage, surgery, chemotherapy. Conclusion Understanding the clinical characteristics of these tumors and factors affecting prognosis can facilitate the selection of more appropriate clinical treatment options.

show abstract

“…give. The remaining 5 studies and our data were selected for our analysis (Table 2) [9][10][11][12][13]. A total of 238 participants were selected for the meta-analysis, of which 111 and 127 patients underwent ART after surgical resection and only surgical resection, respectively.…”

Section: Meta-analysis For Oncological Outcomesmentioning

confidence: 99%

Efficacy of adjuvant radiotherapy for treatment of adrenocortical carcinoma: a retrospective study and an updated meta-analysis

Zhu

Zheng

Shen

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Adrenocortical carcinoma (ACC) is a rare and highly aggressive malignancy. Surgical resection is the standard treatment for localized ACC, but the local recurrence remains high. Adjuvant radiation (ART) has been proposed as a means to reduce recurrence rates in ACC after surgery with conflicting results from nonrandomized studies. We performed a retrospective study and a meta-analysis to determine the impact of ART on survival outcomes. Methods A retrospective study of the adrenocortical cancer database in Peking Union Medical College was conducted. We selected postoperative ACC patients with or without ART. A meta-analysis is also performed to compare the outcomes between ART and only surgical resection in ACC patients. The obtained data were analyzed using SPSS 23.0 and Stata 15.0 statistical software. Differences between two groups were compared using the log-rank test for retrospective analysis and estimated by calculating the odds ratio (OR) and 95% confidence interval (CI) for meta-analysis. Results Of a total of 75 patients available in the database, 12 patients underwent postoperative ART and were matched one to one to patients with only surgical resection. There was no significant difference on overall survival between ART group and control group (log-rank P = 0.149). Locoregional recurrence was diagnosed in 2 of the ART group, and in 4 of the control group (P=0.64). A total of 238 participants were selected for the meta-analysis, of which 111 and 127 patients underwent ART after surgical resection and only surgical resection, respectively. Overall survival is significantly higher in ART group, with an odds ratio (OR) of 2.41 (95% CI of 1.33, 4.38; P = 0.004). Besides, meta-analysis significantly favored ART for locoregional recurrence-free survival and disease-free survival, with an OR of 4.08 and 2.27, respectively. Conclusions Our results show that compared to only surgical resection, ART is an effective postoperative treatment for ACC.

show abstract

Adjuvant radiotherapy for the primary treatment of adrenocortical carcinoma: are we offering the best?

Cited by 21 publications

References 16 publications

Efficacy of adjuvant radiotherapy for treatment of adrenocortical carcinoma: a retrospective study and an updated meta-analysis

Efficacy of adjuvant radiotherapy for treatment of adrenocortical carcinoma: a retrospective study and an updated meta-analysis

Summary of clinical characteristics of common primary adrenal malignancies in adults

Efficacy of adjuvant radiotherapy for treatment of adrenocortical carcinoma: a retrospective study and an updated meta-analysis

Contact Info

Product

Resources

About