Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
7
pubmed:dateCreated
2001-9-26
pubmed:abstractText
Because of the rarity of adrenocortical carcinoma, survival rates and the prognosis for patients who have undergone operation are not well known. The purpose of the French Association of Endocrine Surgery was to evaluate these factors over an 18-year period. A trend study was associated to assess changes in the clinical and biochemical presentations as well as the surgical evolution. A total of 253 patients (158 women, 95 men) with a mean age of 47 years were included. Cushing syndrome was the main clinical presentation (30%), and hormonal studies revealed secreting tumors in 66% of the cases. Altogether, 72% (n = 182) of patients underwent resection for cure, and 41.5% (n = 105) of them had an extensive resection because of metastatic cancer. A lymphadenectomy was performed in 32.5% (n = 89) of the cases. The operative mortality was 5.5% (n = 14). Patients were given mitotane as adjuvant therapy in 53.8% of the cases (n = 135). The results of staging were stage I in 16 patients (6.3%), stage II (local disease) in 126 patients (49.8%), stage III (locoregional disease) in 57 patients (22.5%), and stage IV (metastases) in 54 patients (21.3%). Neither tumor staging nor the rate of curative surgery changed during the study period. More subcostal incisions were performed, and the use of mitotane increased significantly. The 5-year actuarial survival rates were 38% overall, 50% in the curative group, 66% for stage I, 58% for stage II, 24% for stage III, and 0% for stage IV. Multivariate analysis showed that mitotane benefited only the group of patients not operated on for cure. A better prognosis was found in patients operated on after 1988 (p = 0.04), in those with precursor-secreting tumors (p = 0.005), and in those at local stages of the disease (p = 0.0003). Thus mitotane benefited only patients not operated on for cure. Curative resection, precursor secretion, recent diagnosis, and local stage were favorably associated with survival.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Jul
pubmed:issn
0364-2313
pubmed:author
pubmed:issnType
Print
pubmed:volume
25
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
891-7
pubmed:dateRevised
2004-11-17
pubmed:meshHeading
pubmed-meshheading:11572030-Adolescent, pubmed-meshheading:11572030-Adrenal Cortex Neoplasms, pubmed-meshheading:11572030-Adrenocortical Carcinoma, pubmed-meshheading:11572030-Adult, pubmed-meshheading:11572030-Aged, pubmed-meshheading:11572030-Aged, 80 and over, pubmed-meshheading:11572030-Antineoplastic Agents, Hormonal, pubmed-meshheading:11572030-Child, pubmed-meshheading:11572030-Child, Preschool, pubmed-meshheading:11572030-Diagnostic Techniques, Endocrine, pubmed-meshheading:11572030-Endocrine Surgical Procedures, pubmed-meshheading:11572030-Female, pubmed-meshheading:11572030-France, pubmed-meshheading:11572030-Humans, pubmed-meshheading:11572030-Male, pubmed-meshheading:11572030-Middle Aged, pubmed-meshheading:11572030-Mitotane, pubmed-meshheading:11572030-Neoplasm Staging, pubmed-meshheading:11572030-Predictive Value of Tests, pubmed-meshheading:11572030-Prognosis, pubmed-meshheading:11572030-Registries, pubmed-meshheading:11572030-Retrospective Studies, pubmed-meshheading:11572030-Survival Rate, pubmed-meshheading:11572030-Treatment Outcome
pubmed:year
2001
pubmed:articleTitle
Adrenocortical carcinomas: surgical trends and results of a 253-patient series from the French Association of Endocrine Surgeons study group.
pubmed:affiliation
Service de Chirurgie Viscérale et Urgences, Hôpital Général, 3 Rue du Faubourg-Raines, BP 1519, 21033 Dijon, France. pierre.goudet@chu-dijon.fr
pubmed:publicationType
Journal Article