Outcomes of Adjuvant Mitotane after Resection of Adrenocortical Carcinoma: A 13-Institution Study by the US Adrenocortical Carcinoma Group

Journal of the American College of Surgeons
Lauren M PostlewaitShishir K Maithel

Abstract

Current treatment guidelines recommend adjuvant mitotane after resection of adrenocortical carcinoma with high-risk features (eg, tumor rupture, positive margins, positive lymph nodes, high grade, elevated mitotic index, and advanced stage). Limited data exist on the outcomes associated with these practice guidelines. Patients who underwent resection of adrenocortical carcinoma from 1993 to 2014 at the 13 academic institutions of the US Adrenocortical Carcinoma Group were included. Factors associated with mitotane administration were determined. Primary end points were recurrence-free survival (RFS) and overall survival (OS). Of 207 patients, 88 (43%) received adjuvant mitotane. Receipt of mitotane was associated with hormonal secretion (58% vs 32%; p = 0.001), advanced TNM stage (stage IV: 42% vs 23%; p = 0.021), adjuvant chemotherapy (37% vs 5%; p < 0.001), and adjuvant radiation (17% vs 5%; p = 0.01), but was not associated with tumor rupture, margin status, or N-stage. Median follow-up was 44 months. Adjuvant mitotane was associated with decreased RFS (10.0 vs 27.9 months; p = 0.007) and OS (31.7 vs 58.9 months; p = 0.006). On multivariable analysis, mitotane was not independently associated with RFS or OS, and margin statu...Continue Reading

References

Apr 26, 1990·The New England Journal of Medicine·J P LutonP Blondeau
May 15, 1995·Cancer·A A Kasperlik-ZałuskaA M Makowska
Sep 24, 1998·The Journal of Clinical Endocrinology and Metabolism·G DicksteinO Nativ
May 9, 2006·World Journal of Surgery·Electron KebebewAlex McMillan
Jun 8, 2007·The New England Journal of Medicine·Massimo TerzoloAlfredo Berruti
Oct 1, 2008·Endocrine-related Cancer·Fulvia DaffaraMassimo Terzolo
Jan 2, 2010·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·Giovanni LughezzaniPierre I Karakiewicz
Feb 25, 2010·Annals of Surgical Oncology·Stephen B Edge, Carolyn C Compton
Jun 23, 2010·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Alfredo BerrutiMassimo Terzolo
May 2, 2012·Clinical Cancer Research : an Official Journal of the American Association for Cancer Research·Marco VolanteAlfredo Berruti
May 4, 2012·The New England Journal of Medicine·Martin FassnachtUNKNOWN FIRM-ACT Study Group
Dec 5, 2013·The Journal of Clinical Endocrinology and Metabolism·Tobias ElseGary D Hammer
Jun 3, 2014·Therapeutic Drug Monitoring·Thomas M A KerkhofsHarm R Haak
Sep 10, 2014·European Journal of Endocrinology·T M A KerkhofsH R Haak
Dec 21, 2014·World Journal of Surgery·Tarek Ezzat Abdel-AzizRadu Mihai
Jan 7, 2015·The Journal of Clinical Endocrinology and Metabolism·Felix BeuschleinMartin Fassnacht

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Citations

Sep 17, 2016·Journal of Surgical Oncology·Thuy B TranGeorge A Poultsides
Oct 30, 2016·Journal of the American College of Surgeons·Thuy B TranGeorge A Poultsides
Mar 10, 2017·Current Opinion in Endocrinology, Diabetes, and Obesity·Jeena Varghese, Mouhammed Amir Habra
Jan 13, 2017·Medicine·Arthur SchmouchkovitchSylvie Boisramé
Mar 23, 2017·The Journal of Clinical Endocrinology and Metabolism·Alfredo BerrutiMassimo Terzolo
Aug 18, 2018·Expert Review of Anticancer Therapy·Soraya PuglisiMassimo Terzolo
Jul 7, 2020·ANZ Journal of Surgery·David LeongDean Lisewski
Jun 30, 2018·International Journal of Molecular Medicine·Fredrika SvahnCatharina Larsson
Oct 16, 2016·Clinical Cancer Research : an Official Journal of the American Association for Cancer Research·Samuel A Wells
May 1, 2021·Journal of Personalized Medicine·Vittoria BasileMassimo Terzolo
Apr 21, 2021·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Katja Kiseljak-VassiliadesTobias Else
Jul 22, 2021·European Journal of Drug Metabolism and Pharmacokinetics·Malik Salman HaiderRobert Luxenhofer
Aug 6, 2021·Therapeutic Advances in Chronic Disease·Omair A Shariq, Travis J McKenzie
Aug 31, 2020·Annals of Oncology : Official Journal of the European Society for Medical Oncology·M FassnachtUNKNOWN ESMO Guidelines Committee. Electronic address: clinicalguidelines@esmo.org

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