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01-12-2020 | Metastasis | Interventional

Oligometastatic adrenocortical carcinoma: the role of image-guided thermal ablation

Authors: Andrea Veltri, Domenico Basile, Marco Calandri, Chiara Bertaggia, Marco Volante, Francesco Porpiglia, Anna Calabrese, Soraya Puglisi, Vittoria Basile, Massimo Terzolo

Published in: European Radiology | Issue 12/2020

Abstract

Objectives

To evaluate the impact of image-guided ablation of liver and lung metastases from adrenocortical carcinoma (ACC).

Methods

Patients with oligometastatic ACC (liver and lung metastases) who underwent image-guided ablation were retrospectively included in the study. Complete ablation (CA) at the first contrast-enhanced CT control, local tumor progression (LTP), local tumor progression-free survival (LTPFS), liver disease-free survival (LDFS), and overall survival (OS) were evaluated. Correlation between outcomes and other prognostic factors (including Ki67, hormonal secretion, and progression-free survival after primary tumor resection (PR-PFS)) was also analyzed. Kaplan-Meier methods, log-rank tests, and Spearman correlation models were applied.

Results

Thirty-two ACC metastases (4 lung and 28 liver) from 16 patients (10 females; mean age 41 years) were treated with RFA or MWA. A single major adverse event was observed (intrahepatic hematoma with subsequent right hemothorax). One patient (2 lesions) was lost to follow-up. CA was obtained in 97% (29/30). During follow-up, LTP was registered in 7/29 cases (24.1%), with a median LTPFS of 21 months (± 12.6). Metastasis size was significantly higher in case of LTP (20 mm vs. 34.5 mm; p = 0.009) and was an independent predictive factor of local tumor control with an AUC of 0.934 (p = 0.0009). Hepatic progression was observed in 66% of the cases, with a median LDFS of 25 months. Median OS was 48.6 months. PR-PFS and hormonal secretion were independent predictors of OS (p < 0.001 and p = 0.045, respectively).

Conclusions

Image-guided ablation achieves adequate local tumor control of ACC liver and lung metastases, providing a safe and effective treatment option in the multidisciplinary management of the oligometastatic ACC.

Key Points

• Image-guided ablation allows adequate local tumor control in the oligometastatic adrenocortical carcinoma setting.

• After percutaneous thermal ablation, complete ablation was achieved in 29 out of 30 lesions (97%).

• Lesion size together with primary resection disease-free survival and hormonal secretion play a significant role in determining outcomes.

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Title: Oligometastatic adrenocortical carcinoma: the role of image-guided thermal ablation
Authors: Andrea Veltri
Domenico Basile
Marco Calandri
Chiara Bertaggia
Marco Volante
Francesco Porpiglia
Anna Calabrese
Soraya Puglisi
Vittoria Basile
Massimo Terzolo
Publication date: 01-12-2020
Publisher: Springer Berlin Heidelberg
Keywords: Metastasis
Adrenocortical Carcinoma
Interventional Radiology
Published in: European Radiology / Issue 12/2020
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-020-07019-w

ACC 2024 Congress

Springer Medicine

Oligometastatic adrenocortical carcinoma: the role of image-guided thermal ablation

Abstract

Objectives

Methods

Results

Conclusions

Key Points

ACC 2024 Congress

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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