SURGICAL-MANAGEMENT, DNA CONTENT, AND PATIENT SURVIVAL IN ADRENAL-CORTICAL CARCINOMA

Citation
Je. Lee et al., SURGICAL-MANAGEMENT, DNA CONTENT, AND PATIENT SURVIVAL IN ADRENAL-CORTICAL CARCINOMA, Surgery, 118(6), 1995, pp. 1090-1098
Citations number
25
Categorie Soggetti
Surgery
Journal title
ISSN journal
00396060
Volume
118
Issue
6
Year of publication
1995
Pages
1090 - 1098
Database
ISI
SICI code
0039-6060(1995)118:6<1090:SDCAPS>2.0.ZU;2-J
Abstract
Background. Surgical resection is the only potentially curative treatm ent for adrenal cortical carcinoma, yet the value of extended resectio n, palliative resection, and tumor DNA analysis remains unclear. Metho ds. The records of 23 patients with adrenal cortical carcinoma who und erwent primary surgical resection at our institution were retrospectiv ely reviewed. Flow cytometric DNA analysis was performed on primary tu mor tissue from 14 patients. Results. Sixteen of 23 patients underwent complete resection. For these 16 patients the median follow-up was 43 months, the actuarial median survival was 46 months, and the actuaria l 5-year survival rate was 46%. The seven patients who underwent incom plete resection all died of disease with a median survival of 8.5 mont hs. Isolated focal recurrence as the first site of failure occurred in two patients. Only completeness of resection (p = 0.004) and stage at presentation (p = 0.006) were significant prognostic indicators. None of the following predicted a poor prognosis in patients who underwent complete resection: (1) need for extended resection, (2) presence of renal vein or inferior vena cava tumor thrombus, or (3) tumor aneuploi dy (14 of 14 tumors were aneuploid). Conclusions. Long-term survival i s possible in patients with adrenal cortical carcinoma if complete, ma rgin-negative tumor resection can be achieved. Isolated local recurren ce is uncommon after complete resection. Because adrenal cortical carc inomas are consistently aneuploid, tumor DNA content is not a useful p rognostic factor.