Atallah S, et al. – The experience of a tertiary cancer centre in the management of adrenocortical carcinoma (ACC) treated over 40 years, was reviewed. To make treatment recommendations, the current data were insufficient. For better identification of optimum management, use of collaborative databases and consensus about diagnostic and therapeutic guidelines were warranted. Although requiring further research, adjuvant radiation therapy (RT) could be a reasonable option for R1 disease.

Methods

• ACC patients treated between January 1974 and December 2013 were identified, in a retrospective chart review.
• Moreover, the clinicians extracted patient demographics and tumour characteristics.
• They gathered outcomes data, including dates and sites of failure, vital status, and cause of death.
• Kaplan– Meier method was employed to estimate overall survival.
• Moreover, a medline search using PubMed, Ovid, and embase was used to review the literature about the role of rt and any available management guidelines for acc.

Results

• 39 had confirmed ACC, among 81 patients identified during the chart review.
• Surgical resection was performed in 32 patients, including in 2 patients with M1 disease.
• 16 received adjuvant systemic treatment (mitotane or concurrent chemoradiation), among those 32 patients.
• In addition, only 6 patients received adjuvant RT, of whom 3 are still alive (2 living with distant failure).
• 28 patients had died (72%), 10 were living (26%), and 1 had been lost to follow-up, at a median follow-up of 3.8 years.
• 2 experienced local failure, and the rest, distant failure, among the 22 patients for whom failure data were available.