Surgery for recurrent adrenocortical carcinoma: A multicenter retrospective study

Area of Science:

• Oncology
• Surgical Oncology
• Endocrinology

Background:

• Adrenocortical carcinoma (ACC) is a rare endocrine malignancy.
• ACC has a high propensity for recurrence after initial treatment.
• Effective management strategies for recurrent ACC are crucial for patient outcomes.

Purpose of the Study:

• To evaluate the impact of surgical intervention on survival in patients with recurrent adrenocortical carcinoma.
• To compare outcomes between surgical and non-surgical management of recurrent ACC.
• To identify prognostic factors associated with improved survival in recurrent ACC.

Main Methods:

• Retrospective review of 59 patients with recurrent adrenocortical carcinoma.
• Data collected from 5 French University Hospitals between 1980 and 2014.
• Comparison of outcomes for patients undergoing reoperation versus nonoperative management.

Main Results:

• Reoperation for recurrent ACC was associated with significantly greater median overall survival (91 months) compared to nonoperative management (15 months).
• A disease-free interval exceeding 12 months post-initial resection was a favorable prognostic factor.
• Tumor size, stage, and age were not significant prognostic factors; Ki67 <25% showed a trend towards better survival.

Conclusions:

• Surgical management of recurrent adrenocortical carcinoma offers a survival benefit.
• A prolonged disease-free interval (>12 months) is linked to improved overall survival in recurrent ACC.
• These findings support considering reoperation for selected patients with recurrent adrenocortical carcinoma.