Postoperative therapy with mitotane was associated with significantly improved survival (HR 0.11), while the presence of lymphatic metastases was an unfavorable prognostic factor (HR 7.37) in patients with adrenocortical carcinoma.
Cohort (n=72)
No
Does mitotane improve survival in patients with adrenocortical carcinoma?
In patients with adrenocortical carcinoma, the presence of lymphatic metastasis is an unfavorable prognostic factor, while postoperative therapy with mitotane is associated with improved survival.
Hazard Ratio: 0.11 (95% CI 0.04–0.27)
p-value: p=0.001
BACKGROUND: Adrenocortical carcinoma (ACC) is aggressive, but rare tumours that have not been sufficiently studied. The aim of our study was to present the demographic and clinical characteristics of patients with ACC, to determine the overall survival rates, analyse the effect of prognostic factors on survival, as well as to identify favorable and unfavourable predictors of survival. METHOD: The study included 72 patients (42 women and 30 men) with ACC. We analysed the prognostic value of the demographic and clinical characteristics of the patients, tumour characteristics, therapy administered and survival rates. Kaplan-Meier survival curves and the log-rank test were used to estimate the overall and specific survival probabilities and the Cox regression model was used to identify independent prognostic factors for survival. RESULTS: The patients had mean age of 50 years. The 1-, 5-, and 10-year probabilities of survival in patients with ACC were 52.5 %, 41.1 %, and 16.4 %, respectively. The median survival time was 36 months. The results of multivariate Cox regression analysis showed that the presence of lymphatic metastases (HR = 7.37, 95 % CI = 2.31-23.48, p = 0.001) and therapy with mitotane (HR = 0.11, 95 % CI = 0.04-0.27, p = 0.001) were independent prognostic factors for survival. CONCLUSION: The presence of lymphatic metastasis is an unfavourable prognostic factor, while postoperative therapy with mitotane is a favorable prognostic factor for survival in patients with ACC.
Lončar et al. (2015) conducted a cohort in Adrenocortical carcinoma (n=72). Mitotane therapy vs. No mitotane therapy was evaluated on Overall survival (HR 0.11, 95% CI 0.04-0.27, p=0.001). Postoperative therapy with mitotane was associated with significantly improved survival (HR 0.11), while the presence of lymphatic metastases was an unfavorable prognostic factor (HR 7.37) in patients with adrenocortical carcinoma.