Treatment of adrenocortical carcinoma: Contemporary outcomes

Chen, David Y.T.; Sosa, R. Ernest; Scherr, Douglas S.

doi:10.1007/s11934-004-0014-x

Cited by 7 publications

(17 citation statements)

References 49 publications

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“…Majority of the tumors was of high grade at diagnosis and their proportion has been increasing with time. While it is expected that more ACCs would be discovered at earlier stages of the disease due to the increased use of sensitive imaging studies in recent years with subsequent improvement in survival, multiple studies have shown findings to the contrary [ 2 , 7 , 11 - 13 ]. Kebebew et al and Kerkhofs et al reported no changes in the trend of the ACC cases being diagnosed mostly in advanced stages of the disease [ 2 , 7 ].…”

Section: Discussionmentioning

confidence: 99%

The Characteristics and Trends in Adrenocortical Carcinoma: A United States Population Based Study

et al. 2018

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BackgroundAdrenocortical carcinoma (ACC) is a rare malignancy with poor prognosis. Data on the incidence of ACC, however, are scarce and not recent. The purpose of this study was to characterize the tumor and the patients developing ACC over the last four decades using a large population based database.MethodsWe identified all cases of ACC diagnosed between 1973 - 2014 from the Surveillance, Epidemiology, and End Results-18 registry. Descriptive analyses were used for all extracted demographic, clinical, pathological, therapeutic and survival data, and were compared between the four time periods of 1973 to 1984, 1985 to 1994, 1995 to 2004 and 2005 to 2014 using Chi-square tests for categorical variables and one-way analysis of variance for continuous variables.ResultsThere were a total of 2,014 cases of ACC between 1973 and 2014 with an age-adjusted incidence of 1.02 per million populations. The median age at diagnosis was 55 years with the majority of them being females and whites. The proportion of cases by different genders, races and age at diagnosis had not changed significantly over time. These malignancies were mostly the only primary malignancy, unilateral and of high grades at diagnosis. Surgical resection of the tumor remained the mainstay of treatment. However, there was a significant increase in the use of adjuvant radiotherapy, adjuvant chemotherapy and chemotherapy alone in recent times. The median survival time was 17 months, but continues to decrease in recent time periods.ConclusionsACC continues to be a rare malignancy in the United States. However, most cases continue to be diagnosed only in advanced stages and are associated with poor survival. These findings underline the need for specific diagnostics tools with new and more effective treatment options.

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Section: Discussionmentioning

confidence: 99%

The Characteristics and Trends in Adrenocortical Carcinoma: A United States Population Based Study

et al. 2018

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“…Since then, several studies have contradicted this finding. A recent review by Chen et al [12] analyzed studies from the Mayo Clinic, including 58 patients treated since 1980, finding that nonfunctional tumors actually had better prognosis than functional ones and a larger study population from Italy, which included 1000 patients with adrenal incidental masses, discovered by radiographic imaging that 4% of these masses were found to be ACC. This is clearly a higher incidence of ACC than reported previously.…”

Section: Biochemical Functionmentioning

confidence: 99%

“…Both IGF 1 and IGF 2 are involved in differentiation of the adrenal cortex. High levels of these factors may play a role in tumorigenesis and dedifferentiation [12].…”

Section: Tumorigenesismentioning

confidence: 99%

Adrenocortical carcinoma

Roman

2006

Current Opinion in Oncology

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Pre-operative diagnostic advances in positron emission scanning are emerging as promising modalities for confirmation of malignancy of indeterminate adrenal masses. No significant advances in the treatment of adrenocortical carcinoma have been developed. Surgery remains the mainstay for primary and recurrent disease, including select patients with isolated liver metastases. Mitotane has remained the preferred adjuvant treatment agent, showing modest effect in patients with unresectable, residual or metastatic disease. Multi-institutional registries and trials need to be established, with multidisciplinary efforts focused on the development of new therapeutic strategies.

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“…Unfortunately, most ACC patients were seen in advanced stages of the disease, which sometimes makes complete resection difficult or impossible (Pommier and Brennan, 1992;Chen et al, 2004). In out study, 4 patients lost the possibility of operations and died soon (3~10 months) after the diagnosis.…”

Section: Resultsmentioning

confidence: 95%

Estrogen receptor expression in adrenocortical carcinoma

Shen

Qiu

et al. 2009

J. Zhejiang Univ. Sci. B

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Abstract:Objective: Adrenocortical carcinoma (ACC) is a rare but highly malignant tumor, and its diagnosis is mostly delayed and prognosis is poor. We report estrogen receptor (ER) expression in this tumor and our clinical experiences with 17 ACC cases. Methods: The data of the 17 patients (9 females and 8 males, age range from 16 to 69 years, mean age of 42.6 years) with ACC were reviewed, and symptoms, diagnostic procedures, treatment, and results of follow-up were evaluated. Immunohistochemistry was used to detect ER expression in tumor samples from the 17 patients. Results: At the time of diagnosis, 4 tumors were classified as Stage I, 4 as Stage II, 3 as Stage III, and 6 as Stage IV. Eight patients demonstrated positive nuclear immunostaining of ER. The prognosis of patients with ER positive was significantly better (P<0.05) than that of patients with ER negative, with 1-and 5-year survival rates at 86% and 60% for ER-positive patients, and 38% and 0% for ER-negative patients, respectively. Conclusion: ER-positivity may be one of the factors associated with a worse prognosis of ACC.

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Treatment of adrenocortical carcinoma: Contemporary outcomes

Cited by 7 publications

References 49 publications

The Characteristics and Trends in Adrenocortical Carcinoma: A United States Population Based Study

The Characteristics and Trends in Adrenocortical Carcinoma: A United States Population Based Study

Adrenocortical carcinoma

Estrogen receptor expression in adrenocortical carcinoma

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