ObjectiveMany patients with adrenocortical carcinoma (ACC) suffer from tumor recurrence despite radical surgery. Evidence on the post-operative use of mitotane is controversial and no predictors of response are available. We aimed to assess whether adjuvant mitotane treatment may prolong survival in patients with non-metastatic ACC following complete resection and whether ACC patients at high risk of recurrence may benefit from treatment.Design and methodsWe retrospectively reviewed data from 152 non-metastatic ACC patients followed at the San Luigi Gonzaga Hospital: 100 patients were treated with adjuvant mitotane and 52 patients were left untreated following surgery. We assessed a number of potential predictive factors of recurrence and death. Mitotane effect was explored stratifying patients by staging (stage I–II vs stage III), hormone secretion (yes vs no) and Ki67 index.ResultsThe non-treated group had a higher risk of recurrence (HR: 2.79, 95%CI: 1.58–4.91; P ?
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机译：尽管自由基手术，客观患有肾上腺皮质癌（ACC）的患者患有肿瘤复发。有关疗效术后使用的证据是有争议的，并且没有可用的响应预测因子。我们的旨在评估辅助培养物治疗是否可以在完全切除后延长辅助培养基治疗，并且在完全切除后患者的存活率，并且acc患者是否具有高且复发风险的患者可能会受益于治疗。追溯性和方法从152名非转移ACC患者中回顾性审查的数据，然后San Luigi Gonzaga医院：100名患者用佐剂测定疗法治疗，手术后52名患者未经治疗。我们评估了许多潜在的复发和死亡的因素。通过分期进行分层患者（第I-II阶段III），激素分泌（是VS NO）和KI67指数。未治疗组的复发风险较高（HR：2.79,95％CI：1.58 -4.91; p？<？0.001）比Mitotane治疗组，而总体存活率在组之间没有显着差异。激素分泌，魏威斯得分和升高的KI67指数赋予了复发和死亡和死亡阶段的风险更高。佐剂培查烷治疗显着降低了Ki67指数升高的患者死亡风险（p？= 0.005）和III阶段ACC的患者（p？= 0.02）。CONCLUSIONSADJUVANT MITOTANE可以在根本切除的ACC患者中延长无复发的存活具有可接受的毒性，并且还可以在高复发风险的ACC患者的亚组中延长整体存活。
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