Response to mitotane predicts outcome in patients with recurrent adrenal cortical carcinoma. Surgery 2007 Dec;142(6):867-75; discussion 867-75
Date
12/08/2007Pubmed ID
18063070DOI
10.1016/j.surg.2007.09.006Scopus ID
2-s2.0-36649005347 (requires institutional sign-in at Scopus site) 77 CitationsAbstract
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.
Author List
Gonzalez RJ, Tamm EP, Ng C, Phan AT, Vassilopoulou-Sellin R, Perrier ND, Evans DB, Lee JEAuthors
Douglas B. Evans MD Chair, Professor in the Surgery department at Medical College of WisconsinAlexandria T. Phan MD Professor in the Medicine department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdolescentAdrenal Cortex Neoplasms
Adult
Aged
Antineoplastic Agents, Hormonal
Child
Child, Preschool
Combined Modality Therapy
Disease-Free Survival
Female
Follow-Up Studies
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Mitotane
Neoplasm Recurrence, Local
Predictive Value of Tests
Prognosis
