Surgical Management and Clinical Prognosis of Adrenocortical Carcinoma

Abstract

Objective: To study the relationship between surgical management and prognosis of adrenocortical carcinoma (ACC) in order to guide the surgical management of ACC. Methods: Clinical data of 45 cases of ACC treated in our hospital were retrospectively analyzed. The 45 cases included 3 cases in stage I, 12 cases in stage II, 7 cases in stage III, and 23 cases in stage IV. 17 cases underwent complete excision, 14 cases underwent palliative excision, 8 cases had non-operative treatment and 6 cases gave up treatment. All patients were followed up from 2 to 141 months. Results: The average survival time of 31 patients with surgery was 32.46 months, and the average survival time of 14 patients without surgery was 4.75 months. There were statistically significant differences between the two groups (p < 0.01). There were no statistically significant differences between the two groups in survival time in stage III and stage IV (p > 0.05). Conclusions: Surgery is considered to be the only method to cure ACC. For ACC in stage I and II, tumor resection is the most effective treatment, and second surgical operation is recommended for local recurrence. For ACC in stage III, extensive surgical operation is recommended, and for ACC in stage IV, surgical operation has no effect on the prognosis.

Adrenocortical Carcinoma: Clinicopathological Features, Prognostic Factors and Outcome

“…Surgery remains the primary treatment modality and the only chance for cure in these patients [11,12,13]. However, the role of laparoscopic adrenalectomy (LA) in the treatment of patients with AC is controversial.…”

Two Subsequent Metachroneus Solid Tumors: Oncocytic Variant Adrenocortical Carcinoma and Rhabdomyosarcoma of Childhood: Case Report and Literature Review

“…After surgery, the levels of these hormones decreased to an average level in the 24 th hour. The survival rates of stage 1 are higher than others ( 15 ). Our patient was followed-up without treatment after surgery.…”

“…LFS especially is associated with a 40% risk of malignancy before the age of 16 years, high mortality rates, and second primary malignancies, and is an autosomal disorder ( 10 , 11 ). TP53 tumor suppressor gene on chromosome 17p13 in LFS, GNAS 1 variant and abnormalities of 11p15.5 in BWS and variants of the MEN-1 gene on chromosome 11q13 in MEN-1 may be detected in some patients with malignancy ( 12 , 13 , 14 , 15 ). Six per cent of patients with second malignancies and no familial features of LFS had a germline TP53 variant in a sample of 59 patients ( 16 ).…”

The role of surgical treatment in stage IV adrenocortical cancer

“…Период от момента обнаружения опухоли надпочечника до проведения операции составил 5,3 (3)(4)(5)(6)(7)(8)(9)(10)(11) мес. Двое пациентов на предоперационном этапе получили 2 и 3 курса ХТ EDP в целях сокращения объема опухоли и интервал от диагноза до операции у них составил 10 и 11 мес соответственно.…”

“…В остальных 8 случаях АКР прогрессировал и/или развился рецидив, что послужило причиной смерти больных. Средний срок наблюдения составил 21,8 (10,4-33,9) мес, а средний срок до прогрессирования от момента диагноза -11,3 (6,(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)9) Анализ частоты локальных рецидивов в зависимости от радикальности операции показал, что локальный рецидив развился у 1 (20 %) из 5 пациентов, которым была проведена гистологически подтвержденная R0-резекция первичной опухоли, против 100 % в группе больных с резекцией R1/R2 (р = 0,03). Риск развития локального рецидива в первые 8 мес от операции составил 33,3 % и 100 % соответственно (рисунок).…”