Long‐term outcomes in patients with advanced adrenocortical carcinoma after image‐guided locoregional ablation or embolization

Autor: Hayet Amalou, Michal Mauda-Havakuk, Nidhi Jain, Elliot Levy, Bradford J. Wood, Maureen Edgerly, Tito Fojo, Elizabeth Levin, Michael S. Hughes, Victoria L. Anderson, Jaydira Del Rivero, Venkatesh Krishnasamy, Paul Wakim
Jazyk: angličtina
Rok vydání: 2021
Předmět:
0301 basic medicine
Adult
Male
Cancer Research
medicine.medical_specialty
interventional oncology
medicine.medical_treatment
lcsh:RC254-282
Cryosurgery
03 medical and health sciences
Young Adult
0302 clinical medicine
combinational therapy
Adrenocortical Carcinoma
Medicine
Adrenocortical carcinoma
Humans
Radiology
Nuclear Medicine and imaging

Stage (cooking)
Survival rate
Survival analysis
Original Research
Aged
Neoplasm Staging
Retrospective Studies
Radiofrequency Ablation
business.industry
Proportional hazards model
Hazard ratio
locoregional therapy
Cancer
Clinical Cancer Research
Cryoablation
Middle Aged
medicine.disease
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Embolization
Therapeutic

Adrenal Cortex Neoplasms
Survival Rate
030104 developmental biology
endocrine tumors
Treatment Outcome
Oncology
Surgery
Computer-Assisted

030220 oncology & carcinogenesis
Female
Radiology
business
Tomography
X-Ray Computed
Zdroj: Cancer Medicine
Cancer Medicine, Vol 10, Iss 7, Pp 2259-2267 (2021)
ISSN: 2045-7634
Popis: Background To evaluate outcomes and survival rates in patients with metastatic adrenocortical carcinoma (ACC) who were treated with image‐guided locoregional treatments (IGLTs). Purpose To evaluate the overall survival (OS) and clinical impact of IGLT in the management of patients with advanced metastatic ACC. Methods Retrospective review of 39 patients treated with IGLT between 1999 and 2018 was performed. Short‐ and long‐term efficacy of treatments were defined based upon imaging and clinical data. Subgroup survival analysis was performed on patients with metastatic disease at diagnosis (N = 17) and compared with the same stage group from the most recent National Cancer Database (NCDB) report. Statistical analysis was performed using Cox proportional hazards model. Results Treatments were performed at different anatomic sites including liver (N = 46), lung (N = 14), retroperitoneum (N = 5), bone (N = 4), subcutaneous (N = 2), and intracaval (N = 1). Radiofrequency, microwave, cryoablation, or a combination of two modalities (45, 18, 3, 3, respectively) were used in 69 ablation sessions. Intra‐arterial procedures were performed in 12 patients in 18 treatment cycles (range 1–3 per patient). As of a 2019 analysis, 11 patients were alive with a mean follow‐up of 169 months (range 63–292 months) from diagnosis. Two‐ and 5‐year OS rates for all patients were 84.5% and 51%, respectively, and 76.5% and 59% for patients with metastatic disease at diagnosis (N = 17). This compares favorably with an NCDB report of 35% 5‐year survival rate for patients with metastatic disease. Female gender and longer time from diagnosis to first IGLT were found to be predictors of prolonged survival with hazard ratios of 0.23 (p
Treatment of patients with advanced adrenocortical carcinoma with image‐guided locoregional therapies may be associated with prolonged survival, especially in females. Challenging clinical decisions for this rare disease with few effective treatment options may be informed by our two‐decade experience with locoregional therapies. Such a combined approach with surgery, ablation, and/or embolization may be associated with better than previously reported long‐term patient survivals.
Databáze: OpenAIRE