Adrenocortical Carcinoma: Clinicopathological Features, Prognostic Factors and Outcome

Abstract

Objective: The purpose of this study was to investigate the clinicopathological characteristics and treatment outcomes of patients with adrenocortical carcinoma (AC). Methods: Twenty-four patients (10 females and 14 males) diagnosed with AC between 1998 and 2009 were evaluated. Clinical features and outcomes were reviewed. Results: Medianage was 46.5 years. One (4%) patient was classified as stage I, 10 (42%) were classified as stage II, 8 (33%) were classified as stage III and 5 (21%) were classified as stage IV. Tumor sizes ranged from 3 to 22 cm with a mean diameter of 11 cm. Five patients were locally inoperable at initial diagnosis. In addition to surgery, 2 of 19 patients were treated with an adjuvant cisplatin plus etoposide regimen. Sixteen patients were treated with chemotherapy after recurrence. Median survival time was 18 months. The 1- and 5-year overall survival estimates were 73 and 48%, respectively. Mean survival times for male and female patients were 58 and 12 months, respectively (p = 0.046). Early T stage (p = 0.04), lymph node negativity (p < 0.001), the absence of distant metastases (p < 0.001) and early stage (p < 0.001) were correlated with overall survival. Conclusion: AC is a rare disease with a poor prognosis. There are correlations between gender, stage and survival.

Role of Additional Organ Resection in Adrenocortical Carcinoma: Analysis of 167 Patients from the U.S. Adrenocortical Carcinoma Database

“…Third, although we controlled for tumor size, T stage, and N stage in our multivariate analysis, the larger tumors and higher T stage in the AdEBR group were associated with worse prognoses, 7,37 suggesting that our study could have been underpowered to detect the benefit of extra-adrenal organ resection in patients with these large tumors.…”

Management of adrenocortical carcinoma: a consensus statement of the Italian Society of Endocrinology (SIE)

“…By comparing these subjects with those treated with surgery only, OS was not different, while no RFS analy-sis was reported [119]. Anecdotal cases reported a more favorable outcome after an adjuvant etoposide--cisplatin-based chemotherapy [132]. A phase II clinical trial reported that the combination of mitotane plus streptozotocin was effective in an adjuvant setting.…”

Results of Diagnostics and Treatment of Adrenocortical Cancer

“…У 59 больных, проходивших обследование после 2000 г., проводили развернутый анализ, включающий определение в крови уровня адренокортикотропного гормона (АКТГ), дегидроэпиандростерон-сульфата (ДГЭАС), альдостерона, метанефрина, норметанефрина. Кроме того, у 15 больных с АКР изучены современные маркёры злокачественности опухоли -раковый эмбриональный антиген (РЭА), интерлейкин-6 (ИЛ-6) и сосудистый эндотелиальный фактор роста (СЭФР) [20].…”

“…Без проведения лечения пациенты с местно-распространенными и метастатическими формами АКР погибают через 14 и 6 мес соответственно [9,18,23]. После хирургического лечения АКР I-III стадии общая 5-летняя выживаемость варьирует между 37 и 48%, а IV стадии -0% [8,11,15,18,20]. Единственным потенциально радикальным методом лечения можно считать хирургическое удаление опухоли.…”