Endocrine Abstracts

Adrenocortical carcinoma is a rare tumor characterized aggressive growth and poor prognosis. This tumor requires the complex way of treatment, where basic method is surgery.

The aim of this study was to evaluate the long-term outcome and role of surgery in patients with adrenocortical carcinoma.

Methods: From 1998 to 2007, 44 patients were operated for adrenocortical carcinoma (14 cortisol-secreting tumors, 1 virilizing tumor and 29 nonfunctioning tumors). There were 28 women and 16 men, with a medium age 56.3 years (range, 21–72). The mean tumor diameter was 8.4 cm (range, 3–21), weight – 301.2 g (range, 21–2000). The pathological tumor’s stage was I (4 patients), II (8 patients), III (23 patients) and IV (9 patients).

Results: Complete resection was performed in 41 patients. Among them, three patients had combined resection en bloc with the adjacent organs (kidney, spleen and pancreas). Three patients underwent liver segmentectomy and one patient lung resection. Incomplete tumor’s resection was performed in 3 patients. The mean follow-up was 48.2 months (range, 2–96). Twenty-six patients are still alive and 18 were died. The 5-year overall survival, calculated by the Kaplan–Meier method, was 58.5%. The 5-year overall survival rate for patients at stage I, II, III and IV was 98.7, 82.3, 56.7 and 0%, respectively. Local recurrence or metastases were observed in 13 patients. The mean disease-free survival was 26.4 months (range, 6–42). The 3-year disease-free survival was 40.5%. No significant differences in 3-year disease-free survival rates and tumor’s stage were revealed.

Conclusion: Radical surgery with a complete resection of the primary tumor, adjacent organs and, when feasible, solitary metastases offer the best prospects for long-term survival.