What Is the Optimal Duration of Adjuvant Mitotane Therapy in Adrenocortical Carcinoma? An Unanswered Question
| Autor: | Soraya Puglisi, Felix Megerle, Paola Perotti, Isabelle Bourdeau, Marcus Quinkler, Martin Fassnacht, Alfredo Berruti, Ulrich Dischinger, Barbara Altieri, Darko Kastelan, André Lacroix, Massimo Terzolo, Letizia Canu, Paola Loli, Eric Baudin, Rossella Libé, Paola Berchialla, Harm R. Haak, Anna Calabrese, Filippo Ceccato, Vittoria Basile, Felix Beuschlein |
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| Přispěvatelé: | RS: CAPHRI - R1 - Ageing and Long-Term Care, Interne Geneeskunde, University of Zurich, Puglisi, Soraya |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Oncology
Recurrence free sur-vival mitotane medicine.medical_specialty recurrence Treatment duration medicine.medical_treatment 10265 Clinic for Endocrinology and Diabetology adjuvant treatment lcsh:Medicine Medicine (miscellaneous) 610 Medicine & health 030209 endocrinology & metabolism recurrence free survival Article 03 medical and health sciences 0302 clinical medicine Internal medicine adrenocortical cancer medicine Retrospective analysis timing Adrenocortical carcinoma In patient Mitotane ddc:610 Radical surgery business.industry lcsh:R 2701 Medicine (miscellaneous) medicine.disease Discontinuation 030220 oncology & carcinogenesis Adjuvant treatment Adrenocortical cancer Recurrence Timing business Adjuvant medicine.drug |
| Zdroj: | Journal of Personalized Medicine Journal of Personalized Medicine, 11(4):269. Multidisciplinary Digital Publishing Institute (MDPI) Journal of Personalized Medicine, Vol 11, Iss 269, p 269 (2021) Volume 11 Issue 4 |
| ISSN: | 2075-4426 |
| Popis: | A relevant issue on the treatment of adrenocortical carcinoma (ACC) concerns the optimal duration of adjuvant mitotane treatment. We tried to address this question, assessing whether a correlation exists between the duration of adjuvant mitotane treatment and recurrence-free survival (RFS) of patients with ACC. We conducted a multicenter retrospective analysis on 154 ACC patients treated for ≥12 months with adjuvant mitotane after radical surgery and who were free of disease at the mitotane stop. During a median follow-up of 38 months, 19 patients (12.3%) experienced recurrence. We calculated the RFS after mitotane (RFSAM), from the landmark time-point of mitotane discontinuation, to overcome immortal time bias. We found a wide variability in the duration of adjuvant mitotane treatment among different centers and also among patients cared for at the same center, reflecting heterogeneous practice. We did not find any survival advantage in patients treated for longer than 24 months. Moreover, the relationship between treatment duration and the frequency of ACC recurrence was not linear after stratifying our patients in tertiles of length of adjuvant treatment. In conclusion, the present findings do not support the concept that extending adjuvant mitotane treatment over two years is beneficial for ACC patients with low to moderate risk of recurrence. |
| Databáze: | OpenAIRE |
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