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Cited by 158Adrenal and Paraganglionic TumorsRenal cell carcinoma treatmentAdrenal Hormones and Disorders

Recurrence of adrenal cortical carcinoma following resection: surgery alone can achieve results equal to surgery plus mitotane

Grubbs, Elizabeth G., Callender, Glenda G., Xing, Yan, Perrier, Nancy D., Evans, Douglas B., Phan, Alexandria T., Lee, Jeffrey E.·2010·Annals of Surgical Oncology
DOI 10.1245/s10434-009-0716-x
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Abstract

Background A recent nonrandomized interinstitutional study reported that adjuvant mitotane following surgery for adrenocortical carcinoma (ACC) was associated with decreased recurrence. Because of the limitations of this study, we investigated the influences of surgery and adjuvant mitotane in a large series of ACC patients evaluated and treated at a single referral center.Study design Retrospective evaluation of patients followed at a single institution after surgery for ACC.Results 218 patients with ACC underwent primary resection either at the index institution [surgery index (SI), n = 28] or an outside institution [surgery outside (SO), n = 190] and had a median follow-up of 88 months. SI patients had a superior disease-free survival compared with SO patients (median 25 versus 12 months, P = 0.003), and SI patients also had a superior overall survival compared with SO patients (median not reached versus 44 months, P = 0.02). Factors predicting increased risk of recurrence on multivariate analysis were surgery at an outside institution [hazard ratio (HR) 2.56, 95% confidence interval (CI) 1.44-4.53, P = 0.001] and no treatment with adjuvant mitotane (HR 1.95, 95% CI 1.06-3.59, P = 0.03), and those predicting a poorer survival were advanced stage at presentation (P = 0.01) and surgery at an outside institution (HR 2.62, 95% CI 1.31-5.25, P = 0.007).Conclusions The recurrence rate of the index group (50%) in the current series, the overwhelming majority of whom did not receive adjuvant mitotane, is indistinguishable from that reported for those who received adjuvant mitotane (49%) in the recent interinstitutional report, emphasizing the importance of completeness of initial surgery in the management of patients with ACC.

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  • Two studies from M.D. Anderson reported a recurrence rate of 86% in the OA group (154 patients) and 100% in the LA group (6 patients).

    “Two studies published by the M.D. Anderson Cancer Center reported a recurrence rate of 86% in the OA group (154 patients) and 100% in the LA group (6 patients) (251, 257).”

    From Adrenocortical carcinoma (2014) · cites this paper as [257]

  • Local recurrence and peritoneal carcinomatosis was more common in the LA group.

    “Local recurrence and peritoneal carcinomatosis was more common in the LA group.”

    From Adrenocortical carcinoma (2014) · cites this paper as [257]

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Authors
Grubbs, E. G., Callender, G. G., Xing, Y., Perrier, N. D., Evans, D. B., Phan, A. T., & Lee, J. E.
Affiliations
  • The University of Texas MD Anderson Cancer Center (US)
  • Medical College of Wisconsin (US)
Corresponding author
Lee, Jeffrey E.
ORCID
Venue
Annals of Surgical Oncology
Publisher
Springer Science and Business Media LLC
Published
2009-10-23
Volume
17
Issue
1
Pages
263-270
ISSN
  • 1068-9265 (ISSN-L)
  • 1534-4681
DOI
10.1245/s10434-009-0716-x
OpenAlex
W2046048324
Cited by
158
References
20
Citations by year
2026: 3 · 2025: 4 · 2024: 5 · 2023: 6 · 2022: 10 · 2021: 13 · 2020: 18 · 2019: 10 · 2018: 12 · 2017: 10 · 2016: 5 · 2015: 16 · 2014: 11 · 2013: 11 · 2012: 8
FWCI
8.09
Type
journal article
Language
en
Open access
closed
Licence
www.springer.com/tdm (tdm)
Locations
  • Annals of Surgical Oncology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Renal cell carcinoma treatment
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
Keywords
adrenocortical carcinoma, recurrence, adrenalectomy, disease-free survival, overall survival, stage at diagnosis, 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, Neoplasm Staging, Retrospective Studies, Survival Rate, Treatment Outcome, Chemotherapy, Adjuvant, Adrenocortical Carcinoma, Antineoplastic Agents, Hormonal, Young Adult

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