A 20-year experience of adrenocortical carcinoma in single institution

Jung Woo Kim, MD, Seulkee Park, MD, Cho Rok Lee, MD, Sohee Lee, MD, Sang-Wook Kang, MD, Jong Ju Jeong, MD, Woong Youn Chung, MD, Haiyoung Son, MD

Yonsei University Health System

Object :

Adrenocortical carcinoma(ADCC) is a extremely rare tumor with an incidence of approximately 0.5–2 cases per million. Diagnosis is mostly delayed and prognosis is poor. The aim of study was to evaluate the clinical outcomes and prognosis after radical surgery for ADCC in single institution.

Method :

We reviewed total 32 patients with ADCC who underwent radical surgery at YUHS, Korea, between January, 1990 and Feb, 2012.

Result :

Total 32 patients with ADCC were treated by radical surgery in YUHS. There were 16 males and 16 female patients. Age ranged from 3 to 81 years with a average of 42.25. A bimodal age distribution has been observed in patients. Mean tumor size was 12.36cm and mean weight was 560.2g. Concerning to tumor location, 11 cases were located in the right, 19 cases in the left side and 2 cases in bilateral adrenal gland. According to AJCC criteria, 17 patients presented in stage II, 13 in stage IV, 2 in stage III and there was no patient in stage I. There were 11 patients with distant metastasis. Regarding clinical features, 14 patients presented with flank pain, 8 patients presented generalized edema or general weakness. 3 patients presented with virilizing features. Others presented with incidentally discorverd mass and non-specific symptoms. There were 7 patients with functioning tumors (5 cushing and 2 hyperaldosteronism). Of all 32 patients, 14 patients were treated by surgery only, 14 patients by surgery combined with chemotherapy, and 4 patients by surgery combined with radiotherapy. Of the patients, 16 patients are still alive at the present, 11 patients without recurrence and 5 with recurrence. The median overall survival was 85 months(5-year survival, 60.6%). and median disease free survival was 39 months(5-year survival, 41.5%).

Conclusion :

ADCC is a rare disease but, frequently recurs. Surgery is the single most important treatment for ADCC, which can be associated to radiotherapy and adjuvant chemotherapy. According to our study, it showed better survival rates comparing to other studies, because our study included only the patients who underwent radical surgery. So, we need further studies to establish novel treatment modalities for ADCC as a hope of cure for patients.

Session: Poster Presentation

Program Number: P607