Abstract
Introduction
Adrenocortical carcinoma is a rare endocrine malignancy with a high recurrence rate.
The aim of this study was to evaluate the role of surgery for patients with local
or distant recurrent adrenocortical carcinoma and to attempt to identify prognostic
features related to survival benefit in patients undergoing resection of recurrence.
Methods
The data of 47 patients with recurrent adrenocortical carcinoma in West China Hospital,
Sichuan, China, between 2009 and 2019 were retrospectively collected. These patients
were divided into 2 groups according to whether resection of recurrence was performed.
The correlation between overall survival after recurrence and reoperation was evaluated.
Kaplan-Meier and univariate/multivariate Cox regression methods were used to identify
any prognostic factors.
Results
Included in our study were 21 patients who underwent reoperation and 26 patients who
underwent nonoperative treatments were. The operation group had a better median overall
survival after recurrence than the nonoperation group (19 months versus 6.5 months;
P = .007). In the operated group, disease-free interval >12 months (P = .002), complete resection of recurrent adrenocortical carcinoma (P = .041), and R0 resection of the primary tumor (P = .005) were associated with prolonged survival after recurrence.
Conclusions
Reoperation plays an important role in the management of selected patients with recurrent
adrenocortical carcinoma. Disease-free interval, preoperative evaluation for complete
resection, and R0 resection of the primary tumor are important prognostic characteristics
for the resection of recurrent adrenocortical carcinoma. The overall survival after
recurrence was significantly improved for patients who had a disease-free interval
>12 months, and initial R0 resection or complete resection of recurrent adrenocortical
carcinoma is feasible.
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Article info
Publication history
Published online: December 03, 2020
Accepted:
October 31,
2020
Footnotes
Fan Zhang, Zhihong Liu, and Jiayu Liang are first coauthors.
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
