Treatment Outcomes in Patients with Recurrent Adrenocortical Carcinoma.

IF 1.5 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Endocrine Research Pub Date : 2024-09-02 DOI:10.1080/07435800.2024.2397561

Tamara Dojcinovic, Karin Zibar Tomsic, Ivana Dora Vodanovic, Tina Dusek, Ivana Kraljevic, Anja Barac Nekic, Tanja Skoric Polovina, Nikola Knezevic, Ana Marija Alduk, Zrna Antunac Golubic, Darko Kastelan

{"title":"Treatment Outcomes in Patients with Recurrent Adrenocortical Carcinoma.","authors":"Tamara Dojcinovic, Karin Zibar Tomsic, Ivana Dora Vodanovic, Tina Dusek, Ivana Kraljevic, Anja Barac Nekic, Tanja Skoric Polovina, Nikola Knezevic, Ana Marija Alduk, Zrna Antunac Golubic, Darko Kastelan","doi":"10.1080/07435800.2024.2397561","DOIUrl":null,"url":null,"abstract":"Background: While numerous studies have explored treatment outcomes for the overall ACC patient cohort, data on the subpopulation of patients with recurrent disease are limited. Therefore, the aim of this study was to assess treatment outcomes in patients with recurrent ACC.Methods: In this retrospective study, we included 18 patients median age 49 years (42-62); 67% female) diagnosed with recurrent ENSAT stage I-III ACC who underwent either R0 (n = 16) or Rx (n = 2) surgical resection of the tumor.Results: The median time from the initial surgery to ACC recurrence was 29 months (IQR 18-50). Seven patients (39%) manifested local recurrence, while 11 patients (61%) developed distant metastases. The median follow-up duration after tumor recurrence was 32 months (IQR 25-53). Regarding the treatment of ACC recurrence, 10 patients underwent a second surgery either as an alone procedure (n = 4), or in combination with mitotane (n = 4), mitotane and chemotherapy (n = 1), or mitotane combined with radiotherapy (n = 1). The remaining patients received treatment involving chemotherapy±mitotane (n = 4) and locoregional therapy ±chemotherapy (n = 3). One patient chose not to proceed with further management and follow-up. The median PFS was 17 (95% CI 8-26) months while the median OS was not reached. In the multivariate model, increased mortality was associated with advanced age (p = 0.04) and a shorter interval to ACC recurrence (p = 0.03).Conclusion: A significant proportion of patients with ACC recurrence experience disease progression or second recurrence, despite all treatment efforts. Nevertheless, by integrating diverse treatment modalities, many patients have the potential to attain long-term survival.","PeriodicalId":11601,"journal":{"name":"Endocrine Research","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Endocrine Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/07435800.2024.2397561","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}

引用次数: 0

Abstract

Background: While numerous studies have explored treatment outcomes for the overall ACC patient cohort, data on the subpopulation of patients with recurrent disease are limited. Therefore, the aim of this study was to assess treatment outcomes in patients with recurrent ACC.

Methods: In this retrospective study, we included 18 patients median age 49 years (42-62); 67% female) diagnosed with recurrent ENSAT stage I-III ACC who underwent either R0 (n = 16) or Rx (n = 2) surgical resection of the tumor.

Results: The median time from the initial surgery to ACC recurrence was 29 months (IQR 18-50). Seven patients (39%) manifested local recurrence, while 11 patients (61%) developed distant metastases. The median follow-up duration after tumor recurrence was 32 months (IQR 25-53). Regarding the treatment of ACC recurrence, 10 patients underwent a second surgery either as an alone procedure (n = 4), or in combination with mitotane (n = 4), mitotane and chemotherapy (n = 1), or mitotane combined with radiotherapy (n = 1). The remaining patients received treatment involving chemotherapy±mitotane (n = 4) and locoregional therapy ±chemotherapy (n = 3). One patient chose not to proceed with further management and follow-up. The median PFS was 17 (95% CI 8-26) months while the median OS was not reached. In the multivariate model, increased mortality was associated with advanced age (p = 0.04) and a shorter interval to ACC recurrence (p = 0.03).

Conclusion: A significant proportion of patients with ACC recurrence experience disease progression or second recurrence, despite all treatment efforts. Nevertheless, by integrating diverse treatment modalities, many patients have the potential to attain long-term survival.

查看原文本刊更多论文

复发性肾上腺皮质癌患者的治疗效果。

背景：尽管已有大量研究探讨了ACC患者总体的治疗效果，但有关复发患者亚群的数据却十分有限。因此，本研究旨在评估复发性 ACC 患者的治疗效果：在这项回顾性研究中，我们纳入了 18 名被诊断为复发性 ENSAT I-III 期 ACC 的患者（中位年龄 49 岁（42-62）；67% 为女性），他们接受了 R0（16 人）或 Rx（2 人）肿瘤手术切除：从初次手术到 ACC 复发的中位时间为 29 个月（IQR 18-50）。7名患者（39%）出现局部复发，11名患者（61%）出现远处转移。肿瘤复发后的中位随访时间为 32 个月（IQR 25-53）。关于ACC复发的治疗，10名患者接受了第二次手术，包括单独手术（4例）、与米托坦联合手术（4例）、米托坦与化疗联合手术（1例）或米托坦与放疗联合手术（1例）。其余患者接受的治疗包括化疗±米托坦（4例）和局部治疗±化疗（3例）。一名患者选择不再继续治疗和随访。中位 PFS 为 17 个月（95% CI 8-26 个月），而中位 OS 尚未达到。在多变量模型中，死亡率的增加与高龄（p = 0.04）和ACC复发间隔较短（p = 0.03）有关：结论：尽管采取了各种治疗措施，但仍有相当一部分ACC复发患者会出现疾病进展或二次复发。尽管如此，通过整合多种治疗方式，许多患者仍有可能获得长期生存。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Endocrine Research 医学-内分泌学与代谢

CiteScore

4.30

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： This journal publishes original articles relating to endocrinology in the broadest context. Subjects of interest include: receptors and mechanism of action of hormones, methodological advances in the detection and measurement of hormones; structure and chemical properties of hormones. Invitations to submit Brief Reviews are issued to specific authors by the Editors.