Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
BMC Urology
Published in: BMC Urology 1/2015

Open Access 01-12-2015 | Research article

Survival and prognostic factors for adrenocortical carcinoma: a single institution experience

Authors: Zlatibor Loncar, Vladimir Djukic, Vladan Zivaljevic, Tatjana Pekmezovic, Aleksandar Diklic, Svetislav Tatic, Dusko Dundjerovic, Branislav Olujic, Nikola Slijepcevic, Ivan Paunovic

Published in: BMC Urology | Issue 1/2015

Login to get access

Abstract

Background

Adrenocortical carcinoma (ACC) is aggressive, but rare tumours that have not been sufficiently studied. The aim of our study was to present the demographic and clinical characteristics of patients with ACC, to determine the overall survival rates, analyse the effect of prognostic factors on survival, as well as to identify favorable and unfavourable predictors of survival.

Method

The study included 72 patients (42 women and 30 men) with ACC. We analysed the prognostic value of the demographic and clinical characteristics of the patients, tumour characteristics, therapy administered and survival rates. Kaplan-Meier survival curves and the log-rank test were used to estimate the overall and specific survival probabilities and the Cox regression model was used to identify independent prognostic factors for survival.

Results

The patients had mean age of 50 years. The 1-, 5-, and 10-year probabilities of survival in patients with ACC were 52.5 %, 41.1 %, and 16.4 %, respectively. The median survival time was 36 months. The results of multivariate Cox regression analysis showed that the presence of lymphatic metastases (HR = 7.37, 95 % CI = 2.31-23.48, p = 0.001) and therapy with mitotane (HR = 0.11, 95 % CI = 0.04-0.27, p = 0.001) were independent prognostic factors for survival.

Conclusion

The presence of lymphatic metastasis is an unfavourable prognostic factor, while postoperative therapy with mitotane is a favorable prognostic factor for survival in patients with ACC.
Literature
1.
Bilimoria KY, Shen WT, Elaraj D, Bentrem DJ, Winchester DJ, Kebebew E, Sturgeon C. Adrenocortical carcinoma in the United States: treatment utilization and prognostic factors. Cancer. 2008;113:3130-3136.
2.
Kerkhofs TM, Verhoeven RH, Van der Zwan JM, Dieleman J, Kerstens MN, Links TP, et al. Adrenocortical carcinoma: a population-based study on incidence and survival in the Netherlands since 1993. Eur J Cancer. 2013;49:2579–86.CrossRefPubMed
3.
Icard P, Goudet P, Charpenay C, Andreassian B, Carnaille B, Chapuis Y, et al. Adrenocortical carcinomas: surgical trends and results of a 253 patient series from the French Association of Endocrine Surgeons study group. World J Surg. 2001;25:891–7.CrossRefPubMed
4.
Tauchmanovà L, Colao A, Marzano LA, Sparano L, Camera L, Rossi A, et al. Adrenocortical carcinomas: twelve-year prospective experience. World J Surg. 2004;28:896–903.CrossRefPubMed
5.
Kerkhofs TM, Ettaieb MH, Verhoeven RH, Kaspers GJ, Tissing WJ, Loeffen J, et al. Adrenocortical carcinoma in children: First population based clinicopathological study with long-term follow-up. Oncol Rep. 2014;32:2836–44.PubMed
6.
Keskin S, Tas F, Vatansever S. Adrenocortical carcinoma: clinicopathological features, prognostic factors and outcome. Urol Int. 2013;90:435-438.
7.
Dong D, Li H, Yan W, Ji Z, Mao Q. Surgical management and clinical prognosis of adrenocortical carcinoma. Urol Int. 2012;88:400-404.
8.
Dy BM, Strajina V, Cayo AK, Richards ML, Farley DR, Grant CS, et al. Surgical Resection of Synchronously Metastatic Adrenocortical Cancer. Ann Surg Oncol. 2015;22:146–51.CrossRefPubMed
9.
Reibetanz J, Jurowich C, Erdogan I, Nies C, Rayes N, Dralle H, et al. Impact of lymphadenectomy on the oncologic outcome of patients with adrenocortical carcinoma. Ann Surg. 2012;255:363–9.CrossRefPubMed
10.
Ng L, Libertino JM. Adrenocortical carcinoma: diagnosis, evaluation and treatment. J Urol. 2003;169:5-11.
11.
Ferreira U, Nardi Pedro R, Matheus WE, Prudente A, Mendonça Borges G, Rodrigues Netto Jr N. Open surgical treatment of right-sided adrenal carcinomas >15 cm. Urol Int. 2007;78:46–9.CrossRefPubMed
12.
Cooper AB, Habra MA, Grubbs EG, Bednarski BK, Ying AK, Perrier ND, et al. Does laparoscopic adrenalectomy jeopardize oncologic outcomes for patients with adrenocortical carcinoma? Surg Endosc. 2013;27:4026–32.CrossRefPubMed
13.
Miller BS, Ammori JB, Gauger PG, Broome JT, Hammer GD, Doherty GM. Laparoscopic resection is inappropriate in patients with known or suspected adrenocortical carcinoma. World J Surg. 2010;34:1380–5.CrossRefPubMed
14.
Miller BS, Gauger PG, Hammer GD, Doherty GM. Resection of adrenocortical carcinoma is less complete and local recurrence occurs sooner and more often after laparoscopic adrenalectomy than after open adrenalectomy. Surgery. 2012;152:1150–7.CrossRefPubMed
15.
Brix D, Allolio B, Fenske W, Agha A, Dralle H, Jurowich C, et al. German Adrenocortical Carcinoma Registry Group. Laparoscopic versus open adrenalectomy for adrenocortical carcinoma: surgical and oncologic outcome in 152 patients. Eur Urol. 2010;58:609–15.CrossRefPubMed
16.
Polat B, Fassnacht M, Pfreundner L, Guckenberger M, Bratengeier K, Johanssen S, et al. Radiotherapy in adrenocortical carcinoma. Cancer. 2009;115:2816–23.CrossRefPubMed
17.
Fassnacht M, Hahner S, Polat B, Koschker AC, Kenn W, Flentje M, et al. Efficacy of adjuvant radiotherapy of the tumor bed on local recurrence of adrenocortical carcinoma. J Clin Endocrinol Metab. 2006;91:4501–4.CrossRefPubMed
18.
Habra MA, Ejaz S, Feng L, Das P, Deniz F, Grubbs EG, et al. A retrospective cohort analysis of the efficacy of adjuvant radiotherapy after primary surgical resection in patients with adrenocortical carcinoma. J Clin Endocrinol Metab. 2013;98:192–7.CrossRefPubMed
19.
Tritos NA, Cushing GW, Heatley G, Libertino JA. Clinical features and prognostic factors associated with adrenocortical carcinoma: Lahey Clinic Medical Center experience. Am Surg. 2000;66:73-79.
20.
Schulick RD, Brennan MF. Long-term survival after complete resection and repeat resection in patients with adrenocortical carcinoma. Ann Surg Oncol. 1999;6:719–26.CrossRefPubMed
21.
Gomez-Rivera F, Medina-Franco H, Arch-Ferrer JE, Heslin MJ. Adrenocortical carcinoma: a single institution experience. Am Surg. 2005;71:90-94.
22.
Ohwada S, Izumi M, Kawate S, Hamada K, Toya H, Togo N, et al. Surgical outcome of stage III and IV adrenocortical carcinoma. Jpn J Clin Oncol. 2007;37:108–13.CrossRefPubMed
23.
Turbendian HK, Strong VE, Hsu M, Ghossein RA, Fahey TJ 3rd. Adrenocortical carcinoma: the influence of large vessel extension. Surgery. 2010;148:1057-1064.
24.
Mihai R, Iacobone M, Makay O, Moreno P, Frilling A, Kraimps JL, et al. Outcome of operation in patients with adrenocortical cancer invading the inferior vena cava--a European Society of Endocrine Surgeons (ESES) survey. Langenbecks Arch Surg. 2012;397:225–31.CrossRefPubMed
25.
Hermsen IG, Kerkhofs TM, den Butter G, Kievit J, van Eijck CH, van Dijkum EJ N, et al. Surgery in adrenocortical carcinoma: Importance of national cooperation and centralized surgery. Surgery. 2012;152:50–6.CrossRefPubMed
26.
Lombardi CP, Raffaelli M, Boniardi M, De Toma G, Marzano LA, Miccoli P, et al. Adrenocortical carcinoma: effect of hospital volume on patient outcome. Langenbecks Arch Surg. 2012;397:201–7.CrossRefPubMed
27.
Kerkhofs TM, Verhoeven RH, Bonjer HJ, van Dijkum EJ, Vriens MR, De Vries J, et al. Surgery for adrenocortical carcinoma in The Netherlands: analysis of the national cancer registry data. Eur J Endocrinol. 2013;16:83–9.CrossRef
28.
Kerkhofs TM, Baudin E, Terzolo M, Allolio B, Chadarevian R, Mueller HH, et al. Comparison of two mitotane starting dose regimens in patients with advanced adrenocortical carcinoma. J Clin Endocrinol Metab. 2013;98:4759–67.CrossRefPubMed
29.
Terzolo M, Angeli A, Fassnacht M, Daffara F, Tauchmanova L, Conton PA, et al. Adjuvant mitotane treatment for adrenocortical carcinoma. N Engl J Med. 2007;356:2372–80.CrossRefPubMed
30.
Grubbs EG, Callender GG, Xing Y, Perrier ND, Evans DB, Phan AT, et al. Recurrence of adrenal cortical carcinoma following resection: surgery alone can achieve results equal to surgery plus mitotane. Ann Surg Oncol. 2010;17:263–70.CrossRefPubMed
31.
Berruti A, Fassnacht M, Haak H, Else T, Baudin E, Sperone P, et al. Prognostic role of overt hypercortisolism in completely operated patients with adrenocortical cancer. Eur Urol. 2014;65:832–8.CrossRefPubMed
32.
Erdogan I, Deutschbein T, Jurowich C, Kroiss M, Ronchi C, Quinkler M, et al. The role of surgery in the management of recurrent adrenocortical carcinoma. J Clin Endocrinol Metab. 2013;98:181–91.CrossRefPubMed
33.
Hubalewska-Dydejczyk A, Jabrocka-Hybel A, Pach D, Gilis-Januszewska A, Sokolowski G. Current and future medical therapy, and the molecular features of adrenocortical cancer. Recent Pat Anticancer Drug Discov. 2012;7:132–45.CrossRefPubMed
34.
Tacon LJ, Prichard RS, Soon PS, Robinson BG, Clifton-Bligh RJ, Sidhu SB. Current and emerging therapies for advanced adrenocortical carcinoma. Oncologist. 2011;16:36–48.CrossRefPubMedPubMedCentral
35.
Volante M, Buttigliero C, Greco E, Berruti A, Papotti M. Pathological and molecular features of adrenocortical carcinoma: an update. J Clin Pathol. 2008;61:787–93.CrossRefPubMed
Metadata
Title
Survival and prognostic factors for adrenocortical carcinoma: a single institution experience
Authors
Zlatibor Loncar
Vladimir Djukic
Vladan Zivaljevic
Tatjana Pekmezovic
Aleksandar Diklic
Svetislav Tatic
Dusko Dundjerovic
Branislav Olujic
Nikola Slijepcevic
Ivan Paunovic
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Urology / Issue 1/2015
Electronic ISSN: 1471-2490
DOI
https://doi.org/10.1186/s12894-015-0038-1

Other articles of this Issue 1/2015

BMC Urology 1/2015 Go to the issue

Case report

Factor V Leiden mutation triggering four major complications to standard dose cisplatin-chemotherapy for testicular seminoma: a case report

Research article

Impact of preoperative 5α-reductase inhibitors on perioperative blood loss in patients with benign prostatic hyperplasia: a meta-analysis of randomized controlled trials

Research article

Effects of tadalafil treatment after bilateral nerve-sparing radical prostatectomy: quality of life, psychosocial outcomes, and treatment satisfaction results from a randomized, placebo-controlled phase IV study

Research article

Inverse relationship of Rho kinase and myosin-light chain kinase expression in the aging human detrusor smooth muscle

Research article

Which anthropometric measurements including visceral fat, subcutaneous fat, body mass index, and waist circumference could predict the urinary stone composition most?

Research article

Treatment of genital lesions with diode laser vaporization