ECE2017 Guided Posters Endocrine Tumours (13 abstracts)
Outcome of patients with adrenocortical cancer after discontinuation of adjuvant mitotane therapy
Massimo Terzolo 1 , Vittoria Basile 1 , Felix Megerle 2 , Wiebke Hermann 2 , Federica Cicciarella 1 , Rossella Libè 3 , Eric Baudin 4 , Harm Haak 5 , Massimo Mannelli 6 , Marco Boscaro 7 , Marcus Quinkler 8 , Isabelle Bourdeau 9 , Paola Perotti 1 , Stefanie Hahner 2 , Felix Beuschlein 10 & Martin Fassnacht 2
1Department of Clinical and Biological Sciences, University of Turin, Turin, Italy; 2Department of Internal Medicine 1, University of Wurzburg, Wurzburg, Germany; 3Cochin Hospital, Endocrinology Unit, Paris, France; 4Department of Nuclear Medicine and Endocrine Tumors, Institut Gustave Roussy, Villejuif, France; 5Maxima Medisch Centrum, Internal Medicine, Eindhoven, The Netherlands; 6Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy; 7Department of Medicine, University of Padua, Padua, Italy; 8Endokrinologie in Charlottenburg, Berlin, Germany; 9Department of Medicine and Research Centre, University of Montreal, Montreal, Canada; 10University of Munich, Medizinische Klinik und Poliklinik IV, Munich, Germany.
Background: Adjuvant mitotane therapy is frequently used in Europe following surgery for adrenocortical carcinoma (ACC). Management of adjuvant mitotane is mainly empirical and a major open question is the optimal duration of therapy, because no study has ever addressed this issue.
Objective: We aimed to assess the outcome of ACC patients who were treated with adjuvant mitotane for at least one year following surgery and then discontinued therapy for other reasons than ACC recurrence.
Design: We did a retrospective analysis of 132 patients (91 F, 41 M; median age 44 years) with histologically confirmed ACC who were treated at 9 European centres and 1 centre in Canada since 1999.
Results: Tumour stage was ENSAT I, 11%; ENSAT II, 79%; ENSAT III, 20%; hormone secretion was present in 44% and resection status was R0, 83% and Rx, 17%. Median Ki-67 was 10% and Weiss 6. Duration of adjuvant mitotane therapy was 34 months (12–141). Median duration of follow-up was 79 months (31–280), including 34 months after discontinuation (1-263). Seventeen patients (13%) recurred after treatment discontinuation with a recurrence-free survival from surgery of 74 months (31–277) and tumour-free survival after mitotane discontinuation of 32 months (1–263). The only difference in prognostic characteristics between patients with recurrent ACC and the remainders was a higher number of secreting tumours. Interestingly, no recurrence was observed among the 41 patients (31%) treated for >48 months; such patients had similar prognostic characteristics and follow-up duration after mitotane discontinuation than the remainders.
Conclusions: These first results suggest that a prolonged duration of adjuvant mitotane therapy may be associated with better recurrence-free survival.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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