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Cited by 84Adrenal and Paraganglionic TumorsAdrenal Hormones and DisordersRenal cell carcinoma treatment

Response to mitotane predicts outcome in patients with recurrent adrenal cortical carcinoma

Gonzalez, Ricardo J., Tamm, Eric P., Ng, Chaan, Phan, Alexandria T., Vassilopoulou-Sellin, Rena, Perrier, Nancy D., Evans, Douglas B., Lee, Jeffrey E.·2007·Surgery
DOI 10.1016/j.surg.2007.09.006
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Abstract

Background Adrenal cortical carcinoma (ACC) is a rare disease in which recurrence after surgery is common. Mitotane is the primary systemic treatment for recurrent ACC; data are limited regarding the impact of mitotane on recurrent ACC.Methods We reviewed the records of all patients who underwent surgery for ACC evaluated at our institution from 1991 to 2006.Results The median disease-free survival for all 186 patients was 12 months and the median overall survival (OS) was 37 months. Higher stage at presentation (P = .002) and tumor cortisol production (P = .007) were associated with a worse OS. Mitotane was given to 67 evaluable patients with recurrent ACC. A response to mitotane was observed in 13 (19%) of the 67 patients. For patients with stable or responding disease to mitotane, the median OS from date of recurrence was 18 months, compared with 9 months (P = .01) for those who progressed.Conclusions Patients with recurrent ACC who have stable or responding disease to mitotane have a more favorable prognosis than those who progress. Mitotane should be considered in most patients with recurrent ACC, including as preoperative therapy for those with recurrent disease considered for surgical resection.

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Crossref · 10.1016/j.surg.2007.09.006

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  • Cortisol production is an adverse prognostic factor in ACC.

    “some recent studies identified cortisol production as an adverse prognostic factor (12, 85, 244).”

    From Adrenocortical carcinoma (2014) · cites this paper as [244]

  • Tumor extent (stage), specifically presence of distant metastasis and number of organs involved, confers a worse prognosis.

    “Tumor extent (eg, stage), specifically the presence of distant metastasis and number of organs involved in metastatic disease, confers a worse prognosis (243, 244).”

    From Adrenocortical carcinoma (2014) · cites this paper as [244]

  • These results closely correspond with surgical outcomes from other solid malignancies, in which a survival benefit is often seen after complete resection with negative margins but not in those with positive margins.

    “These results closely correspond with the surgical outcomes from a variety of other solid malignancies, in which a survival benefit is often seen in patients after a complete resection with negative margins but not in those with positive margins (19, 91, 244, 267, 273–275).”

    From Adrenocortical carcinoma (2014) · cites this paper as [244]

  • Outcomes after surgical resection alone have remained suboptimal.

    “The outcomes after surgical resection alone have remained suboptimal (11, 244, 267, 269–273).”

    From Adrenocortical carcinoma (2014) · cites this paper as [244]

  • Even with ostensibly complete resections, rates of local recurrence have typically ranged from at least 19% to 34% in patients with no residual disease after surgery.

    “Even with ostensibly complete resections, rates of local recurrence have typically ranged from at least 19% to 34% in those patients with no residual disease after surgery (244, 267, 270).”

    From Adrenocortical carcinoma (2014) · cites this paper as [244]

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Authors
Gonzalez, R. J., Tamm, E. P., Ng, C., Phan, A. T., Vassilopoulou-Sellin, R., Perrier, N. D., Evans, D. B., & Lee, J. E.
Affiliations
The University of Texas MD Anderson Cancer Center (US)
Corresponding author
Lee, Jeffrey E.
ORCID
Venue
Surgery
Publisher
Elsevier BV
Published
2007-12
Volume
142
Issue
6
Pages
867-875
ISSN
0039-6060 (ISSN-L)
DOI
10.1016/j.surg.2007.09.006
OpenAlex
W2028489597
Cited by
84
References
25
Citations by year
2025: 1 · 2024: 1 · 2023: 9 · 2022: 9 · 2021: 5 · 2020: 3 · 2019: 4 · 2018: 8 · 2017: 2 · 2016: 3 · 2015: 5 · 2014: 6 · 2013: 4 · 2012: 6
FWCI
4.94
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Surgery (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Renal cell carcinoma treatment
Keywords
adrenocortical carcinoma, mitotane, treatment response, overall survival, disease-free survival, tumor stage, prognostic factors, preoperative treatment, surgical resection
MeSH terms
Adolescent, Adrenal Cortex Neoplasms, Adult, Aged, Child, Child, Preschool, Combined Modality Therapy, Female, Follow-Up Studies, Humans, Male, Middle Aged, Mitotane, Neoplasm Recurrence, Local, Predictive Value of Tests, Prognosis, Disease-Free Survival, Antineoplastic Agents, Hormonal, Kaplan-Meier Estimate

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