open access

Vol 73, No 2 (2023)
Research paper (original)
Published online: 2023-04-27
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Results of the treatment of adrenocortical cancer patients at the Maria Sklodowska-Curie National Research Institute of Oncology – Krakow Branch

Elżbieta Pluta1, Magdalena Michta1, Anna Patla1, Anna Mucha-Małecka1, Krzysztof Wójcicki1, Piotr B. Madej1
·
Nowotwory. Journal of Oncology 2023;73(2):63-67.
Affiliations
  1. Department of Radiotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, Krakow Branch, Krakow, Poland

open access

Vol 73, No 2 (2023)
Original article
Published online: 2023-04-27

Abstract

Introduction.Adrenocortical carcinoma (ACC) has an incidence of 1–2 cases per million and the 5-year overall survival (OS) is 16–47%. Surgery is the treatment of choice. Post-operative radiotherapy has been shown to prolong overall survival and the purpose of this work was to show our own, first time in Poland, results of adjuvant radiotherapy in tre­ating this disease.

Material and methods.Between 2012 and 2021, 12 patients with ACC were treated. The analyzed group included 9 women and 3 men at a mean age of 44 years (range: 33 to 76 years). A significant increase of tumor size was found in 30% of the subjects. In the analyzed group, 12 patients were qualified to adjuvant radiotherapy, but it was feasible only in 7 patients. The other 5 patients did not undergo radiotherapy. Two patients were disqualified due to metastatic disease and in 3 patients radiotherapy could not be performed due to excessive tumor size and too high a risk of com­plications within the critical organs.

Results.3 out of 7 patients who received adjuvant radiotherapy are still alive and 4 of them died. Mean overall survival time was 32 months. The 12-month overall survival rate was 80%. In the group of 5 patients who have not received radiotherapy, 2 patients are still alive. The mean overall survival time is 13.5 months and the 12-month overall survival rate is 60%.

Conclusions.Due to rapid disease progression and poor prognosis associated with ACC, patients with tumors located in the adrenal gland require urgent surgical treatment at a reference center. Adjuvant radiotherapy improves treatment results significantly, but is not feasible in some patients due to cancer progression or the tumor location. In patients with ACC, it is important to diagnose the disease and to start adequate treatment as early as possible.

Abstract

Introduction.Adrenocortical carcinoma (ACC) has an incidence of 1–2 cases per million and the 5-year overall survival (OS) is 16–47%. Surgery is the treatment of choice. Post-operative radiotherapy has been shown to prolong overall survival and the purpose of this work was to show our own, first time in Poland, results of adjuvant radiotherapy in tre­ating this disease.

Material and methods.Between 2012 and 2021, 12 patients with ACC were treated. The analyzed group included 9 women and 3 men at a mean age of 44 years (range: 33 to 76 years). A significant increase of tumor size was found in 30% of the subjects. In the analyzed group, 12 patients were qualified to adjuvant radiotherapy, but it was feasible only in 7 patients. The other 5 patients did not undergo radiotherapy. Two patients were disqualified due to metastatic disease and in 3 patients radiotherapy could not be performed due to excessive tumor size and too high a risk of com­plications within the critical organs.

Results.3 out of 7 patients who received adjuvant radiotherapy are still alive and 4 of them died. Mean overall survival time was 32 months. The 12-month overall survival rate was 80%. In the group of 5 patients who have not received radiotherapy, 2 patients are still alive. The mean overall survival time is 13.5 months and the 12-month overall survival rate is 60%.

Conclusions.Due to rapid disease progression and poor prognosis associated with ACC, patients with tumors located in the adrenal gland require urgent surgical treatment at a reference center. Adjuvant radiotherapy improves treatment results significantly, but is not feasible in some patients due to cancer progression or the tumor location. In patients with ACC, it is important to diagnose the disease and to start adequate treatment as early as possible.

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Keywords

adrenocortical cancer; surgery; radiotherapy; mitotane

About this article
Title

Results of the treatment of adrenocortical cancer patients at the Maria Sklodowska-Curie National Research Institute of Oncology – Krakow Branch

Journal

Nowotwory. Journal of Oncology

Issue

Vol 73, No 2 (2023)

Article type

Research paper (original)

Pages

63-67

Published online

2023-04-27

Page views

1823

Article views/downloads

176

DOI

10.5603/NJO.2023.0015

Bibliographic record

Nowotwory. Journal of Oncology 2023;73(2):63-67.

Keywords

adrenocortical cancer
surgery
radiotherapy
mitotane

Authors

Elżbieta Pluta
Magdalena Michta
Anna Patla
Anna Mucha-Małecka
Krzysztof Wójcicki
Piotr B. Madej

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