TY - JOUR
T1 - Adjuvant mitotane treatment for adrenocortical carcinoma
AU - Terzolo, Massimo
AU - Angeli, Alberto
AU - Fassnacht, Martin
AU - Daffara, Fulvia
AU - Tauchmanova, Libuse
AU - Conton, Pier Antonio
AU - Rossetto, Ruth
AU - Buci, Lisa
AU - Sperone, Paola
AU - Grossrubatscher, Erika
AU - Reimondo, Giuseppe
AU - Bollito, Enrico
AU - Papotti, Mauro
AU - Saeger, Wolfgang
AU - Hahner, Stefanie
AU - Koschker, Ann Cathrin
AU - Arvat, Emanuela
AU - Ambrosi, Bruno
AU - Loli, Paola
AU - Lombardi, Gaetano
AU - Mannelli, Massimo
AU - Bruzzi, Paolo
AU - Mantero, Franco
AU - Allolio, Bruno
AU - Dogliotti, Luigi
AU - Berruti, Alfredo
PY - 2007/6/7
Y1 - 2007/6/7
N2 - BACKGROUND: Adrenocortical carcinoma is a rare neoplasm characterized by a high risk of recurrence after radical resection. Whether the use of mitotane is beneficial as an adjuvant treatment has been controversial. Our aim was to evaluate the efficacy of adjuvant mitotane in prolonging recurrence-free survival. METHODS: We performed a retrospective analysis involving 177 patients with adrenocortical cancer who had undergone radical surgery at 8 centers in Italy and 47 centers in Germany between 1985 and 2005. Adjuvant mitotane was administered to 47 Italian patients after radical surgery (mitotane group), whereas 55 Italian patients and 75 German patients (control groups 1 and 2, respectively) did not receive adjuvant treatment after surgery. RESULTS: Baseline features in the mitotane group and the control group from Italy were similar; the German patients were significantly older (P = 0.03) and had more stage I or II adrenocortical carcinomas (P = 0.02) than did patients in the mitotane group. Recurrence-free survival was significantly prolonged in the mitotane group, as compared with the two control groups (median recurrence-free survival, 42 months, as compared with 10 months in control group 1 and 25 months in control group 2). Hazard ratios for recurrence were 2.91 (95% confidence interval [CI], 1.77 to 4.78; P
AB - BACKGROUND: Adrenocortical carcinoma is a rare neoplasm characterized by a high risk of recurrence after radical resection. Whether the use of mitotane is beneficial as an adjuvant treatment has been controversial. Our aim was to evaluate the efficacy of adjuvant mitotane in prolonging recurrence-free survival. METHODS: We performed a retrospective analysis involving 177 patients with adrenocortical cancer who had undergone radical surgery at 8 centers in Italy and 47 centers in Germany between 1985 and 2005. Adjuvant mitotane was administered to 47 Italian patients after radical surgery (mitotane group), whereas 55 Italian patients and 75 German patients (control groups 1 and 2, respectively) did not receive adjuvant treatment after surgery. RESULTS: Baseline features in the mitotane group and the control group from Italy were similar; the German patients were significantly older (P = 0.03) and had more stage I or II adrenocortical carcinomas (P = 0.02) than did patients in the mitotane group. Recurrence-free survival was significantly prolonged in the mitotane group, as compared with the two control groups (median recurrence-free survival, 42 months, as compared with 10 months in control group 1 and 25 months in control group 2). Hazard ratios for recurrence were 2.91 (95% confidence interval [CI], 1.77 to 4.78; P
UR - http://www.scopus.com/inward/record.url?scp=34249999500&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=34249999500&partnerID=8YFLogxK
U2 - 10.1056/NEJMoa063360
DO - 10.1056/NEJMoa063360
M3 - Article
C2 - 17554118
AN - SCOPUS:34249999500
VL - 356
SP - 2372
EP - 2380
JO - New England Journal of Medicine
JF - New England Journal of Medicine
SN - 0028-4793
IS - 23
ER -