Response to mitotane predicts outcome in patients with recurrent adrenal cortical carcinoma

Ricardo J. Gonzalez, Eric P. Tamm, Chaan Ng, Alexandria T. Phan, Rena Vassilopoulou-Sellin, Nancy D. Perrier, Douglas B. Evans, Jeffrey E. Lee

Research output: Contribution to journalArticle

58 Scopus citations

Abstract

Background: Adrenal cortical carcinoma (ACC) is a rare disease in which recurrence after surgery is common. Mitotane is the primary systemic treatment for recurrent ACC; data are limited regarding the impact of mitotane on recurrent ACC. Methods: We reviewed the records of all patients who underwent surgery for ACC evaluated at our institution from 1991 to 2006. Results: The median disease-free survival for all 186 patients was 12 months and the median overall survival (OS) was 37 months. Higher stage at presentation (P = .002) and tumor cortisol production (P = .007) were associated with a worse OS. Mitotane was given to 67 evaluable patients with recurrent ACC. A response to mitotane was observed in 13 (19%) of the 67 patients. For patients with stable or responding disease to mitotane, the median OS from date of recurrence was 18 months, compared with 9 months (P = .01) for those who progressed. Conclusions: Patients with recurrent ACC who have stable or responding disease to mitotane have a more favorable prognosis than those who progress. Mitotane should be considered in most patients with recurrent ACC, including as preoperative therapy for those with recurrent disease considered for surgical resection.

Original languageEnglish (US)
Pages (from-to)867-875
Number of pages9
JournalSurgery
Volume142
Issue number6
DOIs
StatePublished - Dec 2007

ASJC Scopus subject areas

  • Surgery

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