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Adjuvant Mitotane Treatment for Adrenocortical Carcinoma

Open access
Terzolo, Massimo, Angeli, Alberto, Fassnacht, Martin, Daffara, Fulvia, Tauchmanova, Libuse, Conton, Pier Antonio, Rossetto, Ruth, Buci, Lisa, Sperone, Paola, Grossrubatscher, Erika, Reimondo, Giuseppe, Bollito, Enrico, Papotti, Mauro, Saeger, Wolfgang, Hahner, Stefanie, Koschker, Ann-Cathrin, Arvat, Emanuela, Ambrosi, Bruno, Loli, Paola, Lombardi, Gaetano, Mannelli, Massimo, Bruzzi, Paolo, Mantero, Franco, Allolio, Bruno, Dogliotti, Luigi, Berruti, Alfredo·2007·New England Journal of Medicine

Abstract

BACKGROUND: Adrenocortical carcinoma is a rare neoplasm characterized by a high risk of recurrence after radical resection. Whether the use of mitotane is beneficial as an adjuvant treatment has been controversial. Our aim was to evaluate the efficacy of adjuvant mitotane in prolonging recurrence-free survival. METHODS: We performed a retrospective analysis involving 177 patients with adrenocortical cancer who had undergone radical surgery at 8 centers in Italy and 47 centers in Germany between 1985 and 2005. Adjuvant mitotane was administered to 47 Italian patients after radical surgery (mitotane group), whereas 55 Italian patients and 75 German patients (control groups 1 and 2, respectively) did not receive adjuvant treatment after surgery. RESULTS: Baseline features in the mitotane group and the control group from Italy were similar; the German patients were significantly older (P=0.03) and had more stage I or II adrenocortical carcinomas (P=0.02) than did patients in the mitotane group. Recurrence-free survival was significantly prolonged in the mitotane group, as compared with the two control groups (median recurrence-free survival, 42 months, as compared with 10 months in control group 1 and 25 months in control group 2). Hazard ratios for recurrence were 2.91 (95% confidence interval [CI], 1.77 to 4.78; P<0.001) and 1.97 (95% CI, 1.21 to 3.20; P=0.005), respectively. Multivariate analysis indicated that mitotane treatment had a significant advantage for recurrence-free survival. Adverse events associated with mitotane were mainly of grade 1 or 2, but temporary dose reduction was needed in 13% of patients. CONCLUSIONS: Adjuvant mitotane may prolong recurrence-free survival in patients with radically resected adrenocortical carcinoma.

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Metadata

Authors
Terzolo, M., Angeli, A., Fassnacht, M., Daffara, F., Tauchmanova, L., Conton, P. A., Rossetto, R., Buci, L., Sperone, P., Grossrubatscher, E., Reimondo, G., Bollito, E., Papotti, M., Saeger, W., Hahner, S., Koschker, A.-C., Arvat, E., Ambrosi, B., Loli, P., Lombardi, G., Mannelli, M., Bruzzi, P., Mantero, F., Allolio, B., Dogliotti, L., & Berruti, A.
Venue
New England Journal of Medicine
Published
2007-06-07
Volume
356
Issue
23
Pages
2372-2380
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
OpenAlex
W2164015349
Cited by
764
References
8
FWCI
40.67
Type
journal article
Language
en
Open access
bronze

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CoChat. (2026). Citation check: Adjuvant Mitotane Treatment for Adrenocortical Carcinoma. https://app.cochat.ai/papers/10.1056/nejmoa063360
The paper
Terzolo, M., Angeli, A., Fassnacht, M., Daffara, F., Tauchmanova, L., Conton, P. A., Rossetto, R., Buci, L., Sperone, P., Grossrubatscher, E., Reimondo, G., Bollito, E., Papotti, M., Saeger, W., Hahner, S., Koschker, A.-C., Arvat, E., Ambrosi, B., Loli, P., . . . Berruti, A. (2007). Adjuvant Mitotane Treatment for Adrenocortical Carcinoma. New England Journal of Medicine. https://doi.org/10.1056/nejmoa063360

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.