Adrenocortical Carcinoma: a Therapeutic Challenge - 44 Cases from a Single Tertiary Care Center in India.
Adrenocortical carcinoma (ACC)
Chemotherapy in ACC
Mitotane in ACC
Radiation therapy (RT) in ACC
Surgery for ACC
Journal
Indian journal of surgical oncology
ISSN: 0975-7651
Titre abrégé: Indian J Surg Oncol
Pays: India
ID NLM: 101532448
Informations de publication
Date de publication:
Jun 2022
Jun 2022
Historique:
received:
23
10
2020
accepted:
01
09
2021
entrez:
5
7
2022
pubmed:
6
7
2022
medline:
6
7
2022
Statut:
ppublish
Résumé
This study was conducted among patients with adrenocortical carcinoma (ACC) to analyze their clinico-pathological profile, management outcomes, and risk factors for local recurrence, systemic metastasis, and survival. The data of patients with ACC who were managed at a single institution between January 2004 and December 2016 was retrospectively collected and analyzed using STATA 13.1. Forty-four patients with a diagnosis of ACC were included in the study. The mean age at presentation was 38.5 ± 14.6 (9-74) with a male preponderance. Functioning tumors represented 59.1% (n = 26), cortisol being the most common hormone secreted. Forty patients (90.9%) underwent surgery, 14 (35%) of whom required an en bloc resection of adjacent organs. Fifteen (37.5%) received radiation (RT) to the postoperative bed while chemotherapy and mitotane were administered in 12 (27.3%) and 9 (20.5%) respectively. The mean follow-up was 34.3 ± 32.7 months. Twelve (30%) patients developed local recurrence, 21 (55.3%) had systemic metastasis, and 15 (34.1%) expired. The mean 1-year and 5-year overall survival rates were 77% and 65.7% respectively. On multivariate analysis, patients with ENSAT stage III/IV were significantly associated with local recurrence (p = 0.011) and metastasis (p = 0.037). Age > 50 (p = 0.003) and ENSAT III/IV (p = 0.017) were significantly associated with mortality on univariate analysis but not on multivariate analysis. In our study population, patients presented at a younger age with a male preponderance. Ninety percent underwent surgery, a subset (35%) requiring resection of adjacent organs to ensure R0 resection. Patients presenting at ENSAT stage I/II have better outcomes.
Identifiants
pubmed: 35782795
doi: 10.1007/s13193-021-01440-3
pii: 1440
pmc: PMC9240166
doi:
Types de publication
Journal Article
Langues
eng
Pagination
251-259Informations de copyright
© Indian Association of Surgical Oncology 2021.
Déclaration de conflit d'intérêts
Conflict of InterestThe authors declare no competing interests.
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