Endocrine Abstracts

Introduction: Adrenocortical carcinoma (ACC) is a rare endocrine malignancy, with an incidence in the literature of 0.5 to 2 cases per million population per year. The most important prognostic factors are stage of cancer at the time of diagnosis and success of the first surgery. However, advanced age, tumor size, functionality, high Ki-67 index (>10%), necrosis, and high mitotic activity are among poor prognostic factors.

Patients and method: Fifteen patients diagnosed with adrenocortical carcinoma, were included in present study. The patients’ data were collected by scanning their electronic records. Age, sex, surgery procedure, resection margin, treatment and prognosis were analyzed.

Results: Ten of 15 patients included in our study were men (66.7%). Descriptive characteristics of the patients and the tumors are provided. R0 resection rate could be achieved in fewer than 50% of the patients. Eight patients were not given postoperative adjuvant therapy. While mitotane was administered to 6 patients, combined systemic chemotherapy was given to 2 patients. Two patients underwent adjuvant radiotherapy. Overall survival rates, median survival time and progression free survival time are provided. Nine patients died during follow-ups. In our study, the rate of development of metastases in patients with complete surgical resection was significantly lower than in patients without R0 resection (P<0.05). There was no statistically significant difference in median survival time, rate of locoregional recurrence and metastases among patients who underwent open or laparoscopic surgery. Mitotane, systemic chemotherapy and radiotherapy had no statistically significant positive effect on survival.

Conclusion: Complete surgical resection of tumoral tissue is the most important factor for long-term survival, but, even if R0 resection is achieved high recurrence rate is seen. Therefore, it is often a need for additional postoperative adjuvant treatment modalities, but the efficacy of them is limited.