Adjuvant Mitotane Treatment for Adrenocortical Carcinoma

• Published in: The New England journal of medicine Vol. 356; no. 23; pp. 2372 - 2380
• Main Authors: Terzolo, Massimo, Angeli, Alberto, Fassnacht, Martin, Daffara, Fulvia, Tauchmanova, Libuse, Conton, Pier Antonio, Rossetto, Ruth, Buci, Lisa, Sperone, Paola, Grossrubatscher, Erika, Reimondo, Giuseppe, Bollito, Enrico, Papotti, Mauro, Saeger, Wolfgang, Hahner, Stefanie, Koschker, Ann-Cathrin, Arvat, Emanuela, Ambrosi, Bruno, Loli, Paola, Lombardi, Gaetano, Mannelli, Massimo, Bruzzi, Paolo, Mantero, Franco, Allolio, Bruno, Dogliotti, Luigi, Berruti, Alfredo
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 07-06-2007
• Subjects: Adrenal Cortex Neoplasms - drug therapy; Adrenal Cortex Neoplasms - mortality; Adrenal Cortex Neoplasms - surgery; Adrenals. Adrenal axis. Renin-angiotensin system (diseases); Adrenocortical Carcinoma - drug therapy; Adrenocortical Carcinoma - mortality; Adrenocortical Carcinoma - surgery; Antineoplastic Agents, Hormonal - adverse effects; Antineoplastic Agents, Hormonal - therapeutic use; Biological and medical sciences; Cancer; Chemotherapy; Chemotherapy, Adjuvant; Clinical outcomes; Endocrinopathies; General aspects; Humans; Malignant tumors; Medical sciences; Medical treatment; Mitotane - adverse effects; Mitotane - therapeutic use; Multivariate Analysis; Neoplasm Recurrence, Local - epidemiology; Neoplasm Recurrence, Local - prevention & control; Retrospective Studies; Survival Analysis; Italy; Germany; Endocrinopathy; Antineoplastic agent; Medicine; Adrenal cortex carcinoma; Adrenal cortex diseases; Mitotane; Adrenal gland diseases; Adjuvant treatment; Malignant tumor
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMoa063360

This retrospective analysis assessed the efficacy of adjuvant mitotane treatment in prolonging recurrence-free survival in adrenocortical cancer, which carries a high risk of recurrence. Survival was significantly prolonged in patients receiving mitotane, as compared with those who did not. Adjuvant mitotane may prolong recurrence-free survival in patients with radically resected adrenocortical carcinoma.
This retrospective analysis assessed the efficacy of adjuvant mitotane treatment in prolonging recurrence-free survival in adrenocortical cancer. Survival was significantly prolonged in patients receiving mitotane, as compared with those who did not.
Adrenocortical carcinoma is a rare neoplasm characterized by a dismal prognosis, with only 16 to 38% of patients surviving for more than 5 years after diagnosis.
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Although a majority of patients have resectable disease at presentation,
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as many as 75 to 85% have a relapse after radical resection.
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This high recurrence rate has prompted investigators to consider the use of adjuvant therapy,
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and mitotane (a synthetic derivative of the insecticide dichlorodiphenyltrichloroethane [DDT]) has been widely used for this purpose.
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However, available studies do not provide data as to whether adjuvant mitotane is efficacious, mainly . . .