Introduction: Adrenal cortical carcinoma (ACC) is a rare malignant neoplasm of epithelial origin, derived from the adrenal cortex, with a high tendency to local invasion and distant metastases.
Aim: The aim was to assess the effect of serum mitotane concentration during mitotane therapy and identify prognostic factors on the survival of ACC patients.
Material and methods: It was a multifactorial analysis of patients from a single endocrinology center. We retrospectively reviewed data on ACC patients (N 56) treated with mitotane between 2002 and 2018. Follow up of included patients was conducted in specific time intervals - after the initation of mitotane therapy. Patients evaluation was based on the comparison of subsequent CT and MR results in the formulation of RECIST. We assessed the progression-free survival time as well as the influence of progression factors. We also evaluated the effect of the therapeutical mitotate concentration on the probability of survival and progression-free survival. We considered the following factors: sex, age, tumor size, tumor secretory activity, tumor resection, reoperation, chemotherapy, radiotherapy and therapeutic concentration of mitotane.
Conclusion: The most important factor affecting progression-free survival is the attainment of the therapeutical concentrations of mitotane - a 3-fold progression in patients who did not have therapeutic control was observed. Among factors improving the prognosis, statistically complete resection (R0) is also present. There was no statistically significant effect of sex and tumor sive as well as age of the patient at the time of diagnosis.
18 - 21 May 2019
European Society of Endocrinology