Abstract No. 228 Clinical Outcomes of Imaging-Guided Localized Treatments in Patients with Adrenocortical Carcinoma: A Retrospective Study

To assess the safety and efficacy of image-guided locoregional therapies (IGLTs) in patients with metastatic or recurrent adrenocortical carcinoma (ACC). A single-institution retrospective study of patients with pathologically confirmed ACC treated from 2006 to 2023 was performed. The efficacy of IGLTs was assessed based on objective imaging (RECIST 1.1) and clinical data. Complications were categorized based on the Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0. A total of 26 patients (18 females, 69.2%) with median age of 56 years (range 39-76) who had a total of 46 IGLT sessions to treat 86 lesions were included (Table 228.1). Treatment modalities included cryoablation (n = 49, 57%), microwave ablation (n = 21, 24%), combined microwave and embolization (n = 8, 9.3%), bland microsphere embolization (n = 3, 3.5%), radioembolization (n=3, 3.5%) and radiofrequency ablation (n = 2, 2.3%). Overall survival for the study cohort was 83% at 1 year and 72% at 2 years. 57 tumors (66.3%) demonstrated complete response on follow-up imaging, while 25 (29.1%) had local tumor recurrence. Local progression-free survival was 73% at 1 year and 63% at 2 years. The time until next therapy at 1 and 2 years was 66% and 55%; 16patients (61.5%) received systemic therapy after the ablation procedures while 10 patients (38.5%) were able to remain off systemic therapy due to successful disease control. There were 5 adverse events, one of which was CTCAE grade 3. IGLT is efficacious and safe for appropriately selected ACC patients, achieving favorable disease control. IGLT can also provide patients with chemotherapy treatment holidays.