Loco-Regional Therapies in Oligometastatic Adrenocortical Carcinoma

Cancers

Julien Hadoux¹  Eric Baudin¹  Alice Boileve¹  Livia Lamartina¹  Matthieu Faron²  Alexandre Delpla³  Charles Roux³  Thierry de Baere³  Lambros Tselikas³  Frederic Deschamps³  Jérome Durand-Labrunie⁴  Segolène Hescot⁵ 

[1] Gustave Roussy, Département D’oncologie Endocrinienne, F-94805 Villejuif, France;Gustave Roussy, Département de Chirurgie, F-94805 Villejuif, France;Gustave Roussy, Département de Radiologie Interventionnelle, F-94805 Villejuif, France;Gustave Roussy, Département de Radiothérapie, F-94805 Villejuif, France;Institut Curie, Département de Médecine Oncologique, F-75005 Paris, France;

关键词: adrenocortical carcinoma;    loco-regional treatments;    oligometastatic;    prognosis factors;    interventional radiology;   

DOI  :  10.3390/cancers14112730

来源: DOAJ

【 摘 要 】

Objective: The recommended first-line treatment for low-tumor-burden ACC (stage IVa ACC) not amenable to radical resection is mitotane in association with loco-regional treatments (LRs). The aim of this study was to determine the patient population that would benefit the most from LR. Materials and methods: This retrospective monocentric expert center chart review study was performed from 2008 to 2021 and included stage IVa patients (≤2 tumoral organs) treated with LR (either radiotherapy, surgery, or interventional radiology). The primary endpoint was disease control (DC). Correlations between DC, time to systemic chemotherapy (TTC), overall survival (OS), and tumor characteristics were analyzed using Kaplan–Meier survival analysis and Cox’s proportional hazards regression model for multivariate analysis. Results: Thirty-four women (57%) and 26 men with a median age of 48.1 years (IQR: 38.3–59.8) were included. One hundred and nine LRs were performed, with a median of 2 (IQR: 1–3) per patient. DC was achieved in 40 out of 60 patients (66.7%). Patients with DC had a significantly longer TTC (HR: 0.27, p < 0.001) and OS (HR: 0.22, p < 0.001). Patients with less than or equal to 5 metastases (HR: 6.15 (95% CI: 1.88–20.0), p = 0.002) or a maximum metastasis diameter below 3 cm had higher rates of DC (HR: 3.78 (95% CI: 1.09–13.14), p = 0.035). Conclusion: stage IVa ACC patients with ≤5 metastases or a maximum metastasis diameter below 3 cm had favorable responses to LR. We propose the name oligometastatic ACC for this subgroup of patients.

【 授权许可】

Unknown