Endocrine Abstracts

Adrenocortical carcinoma (ACC) is rare and aggressive malignancy with poor prognosis. Patients present with hormone excess or a local mass effect, or incidentally. ACC has undergone metastatic spread in 40–70% of patients at the time of diagnosis. Surgical removal is treatment of choice. Standard chemotherapy with mitotane has limited efficacy.

The aim of this paper is to present the results of single tertiary center for diagnosis and treatment of ACC in Serbia. A retrospective review was performed of all patients who were hospitalized from 2005 to 2011. Kaplan–Meier curve was used as the univariate version of survival analysis.

We analyzed 46 patient with ACC (28 females, 18 males), median age 47 years at diagnosis. Ten patients were lost during the follow-up. The mean size of the tumor was 11.6 cm. Fifty-two percent of patients were stage IV (ENSAT staging), 44% stage II, and one patient was stage I. Patients with hormone secreting ACC (40%) were presented with Cushing’s alone (20%), or combined with androgen excess (17%), 54% were asymptomatic. Primary tumor was operated in 88% of patients. Sixty-five percent of patients were treated with mitotane and 26.5% received chemotherapy. At the time of diagnosis 43% of patients had distant metastasis. Mean overall survival was 68 months (95%CI 54–83) with 5 year overall survival 66.7 and 52% in stage IV, and 80% in stage II. The 3 years overall survival was 74%. Median disease free survival was estimated 11 months (range 7–14 months). Significantly higher overall survival was noted in patient treated with mitotan (P<0.0001) comparing to untreated patients. Median overall survival was not statistically different between patient with low, medium and high Ki67 index in this study. In conclusion, we presented the survival in ACC patients in Serbia, our 7 years experience.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.