Adjuvant mitotane treatment for adrenocortical carcinoma

Massimo Terzolo, Alberto Angeli, Martin Fassnacht, Fulvia Daffara, Libuse Tauchmanova, Pier Antonio Conton, Ruth Rossetto, Lisa Buci, Paola Sperone, Erika Grossrubatscher, Giuseppe Reimondo, Enrico Bollito, Mauro Papotti, Wolfgang Saeger, Stefanie Hahner, Ann Cathrin Koschker, Emanuela Arvat, Bruno Ambrosi, Paola Loli, Gaetano LombardiMassimo Mannelli, Paolo Bruzzi, Franco Mantero, Bruno Allolio, Luigi Dogliotti, Alfredo Berruti

Research output: Contribution to journalArticlepeer-review

Abstract

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

Original languageEnglish
Pages (from-to)2372-2380
Number of pages9
JournalNew England Journal of Medicine
Volume356
Issue number23
DOIs
Publication statusPublished - Jun 7 2007

ASJC Scopus subject areas

  • Medicine(all)

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