STUDY TO DETERMINE MULTIMODAL THERAPY IMPACT ON ADRENALECTOMY FOR LOCALIZED ADRENOCORTICAL CARCINOMA AND OVERALL SURVIVAL OF PATIENTS
DOI:
https://doi.org/10.54112/bcsrj.v2023i1.335Abstract
This study aimed to determine the impact of multimodal therapy on adrenalectomy for localized adrenocortical carcinoma (ACC) and the overall survival of patients. The study included 200 patients. A retrospective analysis was conducted on 200 patients diagnosed with localized ACC who underwent adrenalectomy at a medical center. The patients were divided into the multimodal therapy group (n=100) and the adrenalectomy alone group (n=100). Patient characteristics, treatment modalities, pathological findings, and follow-up data were analyzed. The primary outcome measures included recurrence rates, overall survival rates, and treatment-related complications. The 5-year overall survival rate was significantly higher in Group B (68%) compared to Group A (45%) (p < 0.001). Group B also had a higher 5-year disease-free survival rate (54%) compared to Group A (32%) (p = 0.023). The local recurrence rate was lower in Group B (18%) compared to Group A (32%). Treatment-related adverse events occurred slightly more frequently in Group B (22%) than in Group A (15%) but did not significantly impact patient outcomes. Subgroup analyses consistently showed improved overall survival in Group B across different age groups, tumor stages, and histology. Adding multimodal therapy to adrenalectomy for localized ACC significantly improved overall survival, disease-free survival, and reduced local recurrence rates. Multimodal therapy should be considered a potential treatment approach for improving outcomes in ACC patients. Further studies with larger cohorts and prospective designs are needed to confirm these findings and optimize treatment strategies.
Downloads
References
Loncar, Z., Djukic, V., Zivaljevic, V. et al. Survival and prognostic factors for adrenocortical carcinoma: a single institution experience. BMC Urol 15, 43 (2015). https://doi.org/10.1186/s12894-015-0038-1
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.
Hickey K, Shakir A, Shepherd C, Djang R, Patel S. Impact of multimodal therapy on margin status on overall survival for patients undergoing adrenalectomy for localized adrenocortical carcinoma. Indian J Urol. 2022 Oct-Dec;38(4):276-281. doi: 10.4103/iju.iju_77_22. Epub 2022 Oct 1. PMID: 36568465; PMCID: PMC9787443.
Nelson DW, Chang SC, Bandera BC, Fischer TD, Wollman R, Goldfarb M. Adjuvant radiation is associated with improved survival for select patients with non-metastatic adrenocortical carcinoma. Ann Surg Oncol. 2018;25:2060–6.
Tang Y, Liu Z, Zou Z, Liang J, Lu Y, Zhu Y. Benefits of adjuvant mitotane after resection of adrenocortical carcinoma: A systematic review and meta-analysis. Biomed Res Int. 2018;2018:9362108.
Ip JC, Pang TC, Glover AR, Soon P, Clarke S, Richardson A, et al. Improving outcomes in adrenocortical cancer: An Australian perspective. Ann Surg Oncol. 2015;22:2309–16.
Ayala-Ramirez M, Jasim S, Feng L, Ejaz S, Deniz F, Busaidy N, et al. Adrenocortical carcinoma: Clinical outcomes and prognosis of 330 patients at a tertiary care center. Eur J Endocrinol. 2013;169:891–9
Varghese J, Habra MA. Update on adrenocortical carcinoma management and future directions. Curr Opin Endocrinol Diabetes Obes. 2017;24:208–14.
Sabolch A, Else T, Griffith KA, Ben-Josef E, Williams A, Miller BS, Worden F, Hammer GD, Jolly S. Adjuvant radiation therapy improves local control after surgical resection in patients with localized adrenocortical carcinoma. Int J Radiat Oncol Biol Phys. 2015 Jun 1;92(2):252-9. doi: 10.1016/j.ijrobp.2015.01.007. Epub 2015 Mar 5. PMID: 25754631.
Evanoff JD, Patel SG, Hickey KJ, Rensing AJ. Survival characteristics of localized pediatric adrenocortical carcinoma managed with adenectomy: A national cancer center database analysis. J Pediatr Urol. 2021 Oct;17(5):735.e1-735.e6. doi: 10.1016/j.jpurol.2021.06.005. Epub 2021 Jun 9. PMID: 34210620.
Staubitz, J., Hoppe-Lotichius, M., Baumgart, J. et al. Survival After Adrenalectomy for Metastatic Hepatocellular Carcinoma: A 25-year Institutional Experience. World J Surg 45, 1118–1125 (2021). https://doi.org/10.1007/s00268-020-05909-0
Lv, Zemin, et al. "Long-Term Survival Outcomes of Pediatric Adrenal Malignancies: An Analysis with the Upstaged SEER Registry during 2000-2019." Frontiers in Endocrinology, vol. 13, 2022, https://doi.org/10.3389/fendo.2022.977105.
Gaillard, M.; Razafinimanana, M.; Challine, A.; Araujo, R.L.C.; Libé, R.; Sibony, M.; Barat, M.; Bertherat, J.; Dousset, B.; Fuks, D.; Gaujoux, S. Laparoscopic or Open Adrenalectomy for Stage I–II Adrenocortical Carcinoma: A Retrospective Study. J. Clin. Med. 2023, 12, 3698. https://doi.org/10.3390/jcm12113698
NG, LINDA, and LIBERTINO, JOHN. "Adrenocortical Carcinoma: Diagnosis, Evaluation and Treatment." The Journal of Urology, vol. 169, no. 1, 2003, pp. 5-11, https://doi.org/10.1016/S0022-5347(05)64023-2.
Gaujoux, S.; Mihai, R. European Society of Endocrine Surgeons (ESES) and European Network for the Study of Adrenal Tumours (ENSAT) recommendations for the surgical management of adrenocortical carcinoma. Br. J. Surg. 2017, 104, 358–376
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 K HUSSAIN , A ALI , AH MEMON , A AHMAD , B AHMED
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.