| Popis: |
The initial aim of this work was narrow, with a translational focus foremost. It was, in brief, to determine if microRNAs (miRNAs), replaced in adrenocortical carcinoma (ACC), could mitigate chemoresistance to commonly used adjuvant treatments, including doxorubicin and mitotane. This was in recognition that complete surgical resection offers the best chance of a cure, with response to adjuvant treatment heterogeneous, at best. However, ACC often presents late with advanced disease, as symptoms may be non-specific, and diagnosis is often late. Additionally, ACC can rapidly grow and upstage from diagnosis to resection. Finally, as a rare cancer, expert knowledge in the management of ACC is centred at quaternary referral centres. To fulfil the original aim, it was necessary to review patients’ clinical files to correlate the course of their disease with adjuvant treatments given. It became apparent that there was a deficit in the Australasian literature detailing long-term management approaches and outcomes of ACC in quaternary referral centres. This was in stark contrast to publications from North American, European and Asian centres where ACC is recognised as a challenging rare cancer needing ongoing clinical and scientific study. With over 21 years of specialist multidisciplinary management, inclusive of 29 patients managed primarily and 7 other patients referred for quaternary care, outcomes were in line with those published from international centres. Low Ki-67 index ( |
