Andrenocortical carcinomas: Twelve-year prospective experience

Libuse Tauchmanovà, Annamaria Colao, Luigi Antonio Marzano, Lucianna Sparano, Luigi Camera, Annalisa Rossi, Giovanna Palmieri, Ettore Marzano, Marco Salvatore, Guido Pettinato, Gaetano Lombardi, Riccardo Rossi

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Abstract

Adrenocortical carcinoma (AC) is a rare tumor with poor prognosis. Twenty-two patients (14 F, 8 M; age 22 to 59 years; median, 43 years) with AC were evaluated prospectively in a single center: tumor stage was I-II in 12 cases and III-IV in 10. The overall survival in our cohort was 41.6 ± 42 months; 16 subjects are still alive. Curative surgery was followed by longer survival than debulking or no surgery (p <0.0001). The first relapse was highly predictive for further recurrences. Recurrent ACs were progressively more aggressive, and they occurred with variable but ever shorter intervals. At diagnosis, 14 patients (63.5%) presented with features of clear adrenocortical hyperactivity. Despite the absence of clinical signs of hormonal excess, all other patients presented some abnormalities of steroid secretion. The most common clinical findingwas a recent diagnosis of moderate-to-severe hypertension (68%), poorly controlled by pharmacological treatment, often associated with multiple cardiovascular risk factors. High mitotic rate and undifferentiated polymorph cellular pattern were associated with worse prognosis. Response to treatments other than surgery (mitotane chemotherapy) was better in patients treated early after the first surgery. In conclusion, curative surgery was the most effective treatment. Monitoring arterial pressure, endocrine parameters, and metabolic parameters can be helpful for the early detection of AC recurrences.

Original languageEnglish
Pages (from-to)896-903
Number of pages8
JournalWorld Journal of Surgery
Volume28
Issue number9
DOIs
Publication statusPublished - Sep 2004

ASJC Scopus subject areas

  • Surgery

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    Tauchmanovà, L., Colao, A., Marzano, L. A., Sparano, L., Camera, L., Rossi, A., Palmieri, G., Marzano, E., Salvatore, M., Pettinato, G., Lombardi, G., & Rossi, R. (2004). Andrenocortical carcinomas: Twelve-year prospective experience. World Journal of Surgery, 28(9), 896-903. https://doi.org/10.1007/s00268-004-7296-5