Treatment of adrenocortical carcinoma: oncological and endocrine outcomes.
Journal
Current opinion in urology
ISSN: 1473-6586
Titre abrégé: Curr Opin Urol
Pays: United States
ID NLM: 9200621
Informations de publication
Date de publication:
01 01 2023
01 01 2023
Historique:
entrez:
29
11
2022
pubmed:
30
11
2022
medline:
1
12
2022
Statut:
ppublish
Résumé
Adrenocortical carcinoma (ACC) is a rare, aggressive disease with a paucity of data and great variability between published studies regarding its treatment. This review provides information on current clinical management and oncological and endocrine outcomes. Complete surgical resection is the only potentially curative treatment for adrenocortical carcinoma (ACC). Adjuvant mitotane treatment is recommended in patients with favourable/intermediate prognosis. As part of the endocrine follow-up, steroid hormones and thyroid hormones may be decreased or increased and may need to be substituted or suppressed. Recurrences are common. If the disease-free interval is more than 12 months, surgery is a treatment if complete resection is feasible. In advanced/metastatic ACC patients, the prognosis is poor. Mitotane monotherapy is only appropriate for patients with low tumour burden and indolent disease. Patients with unfavourable prognosis should be treated with aggressive cytotoxic therapy. Patients requiring third-line treatment should be considered for clinical trials. Immunotherapy and targeted therapy are currently being investigated, but have so far yielded only unsatisfactory results. There is scarce evidence for the treatment of ACC, which often complicates clinical decision-making. Patients who progress on EDP-M should be treated in clinical trials.
Identifiants
pubmed: 36444650
doi: 10.1097/MOU.0000000000001045
pii: 00042307-202301000-00010
doi:
Substances chimiques
Mitotane
78E4J5IB5J
Types de publication
Review
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
50-58Informations de copyright
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
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