Long‐term outcomes in patients with advanced adrenocortical carcinoma after image‐guided locoregional ablation or embolization

Abstract

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Availability of Interventional Oncology in Germany in the Years 2018 and 2019 – Results from a Nationwide Database (DeGIR Registry Data)

“…Minimally invasive interventional oncological procedures have increasingly become common alongside the standard therapeutic procedures of surgery, oncology and radiotherapy [13][14][15]. In patients in a general state of health suitable for therapy, they represent a complementary, although in some cases also competitive, therapeutic approach and, particularly in multimorbid patients, are often one of the last options before the decision is made to provide best supportive care [13,16,17]. In practical patient care, however, in addition to the evidence-based therapy recommendation, the availability of the intended procedure is often a decisive criterion for optimal therapy tailored to the patient.…”

“…This is also shown by the absolute distribution of oncological interventions performed in 2018 and 2019, as the mean value of documented interventions per admionistrative district was 599. Individual districts (Bremen (17), Dessau (38), Halle (28) as well as Magdeburg (43)) were more than one standard deviation (414) below the mean. To avoid bias in results due to regions with different population densities, oncological interventions in 2018 and 2019 were standardized to one million population at the state level.…”

“…Minimal-invasive Verfahren der interventionellen Onkologie haben sich zunehmend neben den "klassischen" Therapieverfahren der Chirurgie, Onkologie sowie Strahlentherapie etabliert [13][14][15]. Sie stellen bei Patienten im therapiefähigen Allgemeinzustand einen komplementären, teilweise allerdings auch kompetitiven Therapieansatz dar und sind insbesondere bei multimorbiden Patienten häufig eine der letzten Optionen vor der Entscheidung zur "Best Supportive Care" [13,16,17]. In der praktischen Patientenversorgung ist allerdings neben der evidenzbasierten Therapieempfehlung häufig die Verfügbarkeit des vorgesehenen Verfahrens ein entscheidendes Kriterium für die auf den Patienten abgestimmte optimale Therapie.…”

“…Hier lag der Mittelwert der dokumentierten Interventionen pro Regierungsbezirk bei 599. Mit Bremen (17), Dessau (38), Halle (28) sowie Magdeburg (43) lagen einzelne Regierungsbezirke mehr als eine Standardabweichung (414) unterhalb des Mittelwerts. Um Verzerrungen der Ergebnisse durch Regionen mit unterschiedlicher Bevölkerungsdichte zu vermeiden, wurden auf Bundeslandebene die onkologischen Interventionen aus den Jahren 2018 und 2019 auf eine Million Einwohner genormt.…”

Tumor Doubling Time Using CT Volumetric Segmentation in Metastatic Adrenocortical Carcinoma

“…Ripley et al also reported survival benefits in patients with metastatic ACC who underwent resection or radiofrequency ablation of liver lesions with 5-year actuarial survivals of 29% and 29%, respectively [ 26 ]. Furthermore, Mauda-Havakuk et al reported that image-guided locoregional imaging including the liver is associated with prolonged survival [ 27 ]. These and other studies argue for an aggressive approach to liver metastases as to improve survival within the context of worse prognosis with advanced liver disease [ 28 , 29 ].…”