Endocrine Abstracts

Subject: Treatment options for adrenocortical carcinoma (ACC) are still unsatisfactory. We could recently demonstrate that several patients with ACC exhibit a high and specific uptake of 123I-Iodometomidate (123I-IMTO). Therefore, we investigated if 131I-IMTO holds potential for radiotherapy in ACC.Methods: Dosimetry with 40 MBq I-131-IMTO was performed over 5 days in 7 patients and calculated activities were administered on a compassionate use basis in ...

Adrenocortical carcinoma (ACC) is a rare and heterogeneous malignancy with incompletely understood pathogenesis and poor prognosis. Recent data from the German ACC Registry (n=377) demonstrate an overall 5-year survival of 46%. Survival is clearly stage-dependent (P<0.01) with a 5-year survival of 85% in stage 1, 56% in stage 2, 42% in stage 3, and 16% in stage 4, respectively.In stages I –III open surgery by an expert surgeon aimi...

Introduction: Surgery is the established first line treatment in adrenocortical carcinoma (ACC). For benign adrenal tumours, laparoscopic adrenalectomy (LA) has become the treatment of choice. However, the role of LA in ACC remains highly controversial. Data from the German ACC Registry were used to evaluate the technical feasibility of LA in ACC and to compare the long-term outcome after LA with the results of open adrenalectomy (OA).Methods: Out of 521...

Standard treatment of adrenocortical carcinoma (ACC) comprises adrenolytic therapy with mitotane. Prolongation of bleeding time has previously been observed based on a series of 7 patients (Haak et al. 1991). As patients with ACC frequently undergo surgery for local recurrence or metastases, we have studied the effect of mitotane on coagulation in 44 patients with ACC before and/or during treatment with mitotane (total sample size n=62).Pla...

Background: The multi-tyrosine kinase inhibitor sunitinib is approved for advanced renal cell carcinoma and gastrointestinal stroma tumors. It targets both tumor vessels and malignant cells. Animal experiments have pointed to a direct adrenotoxic effect of the drug.Aims: We hypothesized that sunitinib may inhibit proliferation of adrenocortical cancer (ACC) cells and influence adrenal steroid hormone synthesis.Results: Sunitinib re...

Introduction: The role of surgery for recurrent ACC is not well defined. Therefore, we used the German ACC Registry to evaluate treatment modalities after first recurrence in patients amenable to surgery.Methods: Patients with recurrence after radical resection and follow-up data were included. Patients with extensive metastasized disease (>2 tumoral organs, peritoneal carcinomatosis) were excluded. Progression-free and overall survival (PFS/OS) were...

Subject: Adrenal tumours (AT) are often detected incidentally and represent a variety of differential diagnoses with variable therapeutic consequences. We have recently developed [123I]Iodometomidate ([123I]IMTO), that specifically binds to adrenal CYP11B enzymes as a SPECT tracer for adrenal scintigraphy. This radiotracer is now evaluated in patients with adrenal tumours in an ongoing clinical trial. The study was approved by the ethical committee and pa...

Objectives: Adrenocortical carcinoma (ACC) is a rare malignancy with incompletely understood pathogenesis and poor prognosis. Overexpression of epidermal growth factor receptor (EGFR) has been demonstrated in several tumors and is partly associated with a more aggressive phenotype and a worse prognosis. In addition, targeting the EGFR tyrosine kinase represents a successful new therapeutic strategy, e.g. in non-small cell lung cancer. Therefore, we investigated the role of EGF...

Adrenocortical carcinoma (ACC) is a rare disease with poor prognosis. Accordingly, in many cases, the attending doctors have no previous experience with the disease. The aim of our study was to evaluate the quality of care in a large number of patients with ACC in Germany. Data from 263 adult patients of the German ACC registry were analyzed with regard to the following parameters: time to diagnosis, hormonal assessment, imaging, histopathological documentation, follow-up. The...

Even after complete resection, patients with ACC have a high risk of relapse, and adjuvant treatment with mitotane is frequently recommended. Although mitotane has significant efficacy in this setting, it is associated with a wide range of side effects. As survival is highly variable, prognostic factors are of great interest to better guide adjuvant therapy after radical resection.We analyzed clinical and histopathological data of patients without distan...