STUDY TO DETERMINE MULTIMODAL THERAPY IMPACT ON ADRENALECTOMY FOR LOCALIZED ADRENOCORTICAL CARCINOMA AND OVERALL SURVIVAL OF PATIENTS

Authors

  • K HUSSAIN Department of Urology, Gujranwala Teaching Hospital Gujranwala, Pakistan
  • A ALI Department of Urology, Gujranwala Teaching Hospital Gujranwala, Pakistan
  • AH MEMON Department of Urology, People's University of Medical and Health Sciences for Women Nawabshah, Pakistan
  • A AHMAD Department of Pharmacy, The University of Lahore (UOL), Pakistan
  • B AHMED Department of Urology, Gujranwala Teaching Hospital Gujranwala, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2023i1.335

Abstract

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.

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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

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Published

2023-06-27

How to Cite

HUSSAIN , K., ALI , A., MEMON , A., AHMAD , A., & AHMED , B. (2023). STUDY TO DETERMINE MULTIMODAL THERAPY IMPACT ON ADRENALECTOMY FOR LOCALIZED ADRENOCORTICAL CARCINOMA AND OVERALL SURVIVAL OF PATIENTS. Biological and Clinical Sciences Research Journal, 2023(1), 335. https://doi.org/10.54112/bcsrj.v2023i1.335

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