Guénolé Simon1, François Pattou2, Eric Mirallié1, Jean Christophe Lifante3, Claire Nominé4, Vincent Arnault5, Loïc de Calan5, Cécile Caillard1, Bruno Carnaille2, Laurent Brunaud4, Nathalie Laplace3, Robert Caiazzo2, Claire Blanchard6. 1. Clinique de Chirurgie Digestive et Endocrinienne (CCDE), Institut des Maladies de l'Appareil Digestif (IMAD), Centre Hospitalier Universitaire (CHU) Nantes-Hôtel Dieu, Nantes, France. 2. Chirurgie Générale et Endocrinienne, CHU Lille, Lille, France. 3. Service de Chirurgie Endocrinienne et Générale, CHU Lyon, Lyon, France. 4. Service de Chirurgie Digestive, Hépatobiliaire, Pancréatique, Endocrinienne et Cancérologique, CHU Nancy, Nancy, France. 5. Service de Chirurgie Digestive Endocrinienne et Bariatrique, et Transplantation hépatique, CHU Tours, Tours, France. 6. Clinique de Chirurgie Digestive et Endocrinienne (CCDE), Institut des Maladies de l'Appareil Digestif (IMAD), Centre Hospitalier Universitaire (CHU) Nantes-Hôtel Dieu, Nantes, France. Electronic address: claire.blanchard@chu-nantes.fr.
Abstract
BACKGROUND: Adrenocortical carcinoma is a rare neoplasm with a high rate of recurrence. We studied the impact of surgery on the survival in recurrent adrenocortical carcinoma patients. METHODS: We performed a retrospective review of patients with recurrent adrenocortical carcinoma, managed in 5 French University Hospitals between 1980 and 2014. We compared surgery and medical management for ACC recurrence. RESULTS: Fifty-nine patients were included, 46 of whom had an initial R0 resection. Twenty-nine patients underwent reoperation for recurrence, while 30 had nonoperative treatments. Operated patients had a greater median overall survival after recurrence than nonoperated patients (91 vs 15 months; P < .001). Patients operated on for local or distant recurrence had similar overall survival (110 vs 91 months; P = .81). In nonoperated patients, types of medical managements did not impact survival. Surgery for recurrence (P = .037) and a disease-free interval between initial resection and recurrence >12 months (P = .059) were both prognostic factors for improved survival, whereas age, stage, and tumor size (P ≥ .2 each) were not. A Ki67 <25% tended to be associated with better overall survival (P = .051). CONCLUSION: Both surgery for recurrence and disease-free interval between the initial resection of an adrenocortical carcinoma and recurrence >12 months are associated with better overall survival.
BACKGROUND:Adrenocortical carcinoma is a rare neoplasm with a high rate of recurrence. We studied the impact of surgery on the survival in recurrent adrenocortical carcinomapatients. METHODS: We performed a retrospective review of patients with recurrent adrenocortical carcinoma, managed in 5 French University Hospitals between 1980 and 2014. We compared surgery and medical management for ACC recurrence. RESULTS: Fifty-nine patients were included, 46 of whom had an initial R0 resection. Twenty-nine patients underwent reoperation for recurrence, while 30 had nonoperative treatments. Operated patients had a greater median overall survival after recurrence than nonoperated patients (91 vs 15 months; P < .001). Patients operated on for local or distant recurrence had similar overall survival (110 vs 91 months; P = .81). In nonoperated patients, types of medical managements did not impact survival. Surgery for recurrence (P = .037) and a disease-free interval between initial resection and recurrence >12 months (P = .059) were both prognostic factors for improved survival, whereas age, stage, and tumor size (P ≥ .2 each) were not. A Ki67 <25% tended to be associated with better overall survival (P = .051). CONCLUSION: Both surgery for recurrence and disease-free interval between the initial resection of an adrenocortical carcinoma and recurrence >12 months are associated with better overall survival.
Authors: Winifred Lo; Reed I Ayabe; Christine M Kariya; Meghan L Good; Seth M Steinberg; Jeremy L Davis; Robert T Ripley; Jonathan M Hernandez Journal: J Surg Oncol Date: 2019-12-06 Impact factor: 2.885
Authors: Johannes Baur; Tjark-Ole Büntemeyer; Felix Megerle; Timo Deutschbein; Christine Spitzweg; Marcus Quinkler; Peter Nawroth; Matthias Kroiss; Christoph-Thomas Germer; Martin Fassnacht; Ulrich Steger Journal: BMC Cancer Date: 2017-08-04 Impact factor: 4.430