1 - A Large Retrospective Series of Adrenocortical Carcinoma (ACC) in a Canadian Referral Centre: ACC is Frequently Diagnosed in Young Adults and at Late Stages

Poirier, Jonathan; Alguire, Catherine; Olney, Harold J.; Latour, Mathieu; Gagnon, Nadia; Karakiewicz, Pierre I.; Perrotte, Paul; Lacroix, André; Bourdeau, Isabelle

doi:10.1016/j.jcjd.2019.07.008

Cited by 1 publication

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“…Hormonal hypersecretion is described in up to 75% of ACCs 3 . Cortisol hypersecretion is most common, ranging from 23% to 50%, followed by DHEAS 9–19%, a combination and rarely aldosterone secreting only 10,19,20 . A total of 65% of patients in our series presented with hypercortisolism, 25% with androgen excess and 12% a combination of both.…”

Section: Discussionmentioning

confidence: 77%

“…3 Cortisol hypersecretion is most common, ranging from 23% to 50%, followed by DHEAS 9-19%, a combination and rarely aldosterone secreting only. 10,19,20 A total of 65% of patients in our series presented with hypercortisolism, 25% with androgen excess and 12% a combination of both. The majority of patients had a preoperative working diagnosis of ACC based on high PET SUV uptakes and CT characteristics.…”

Section: Discussionmentioning

confidence: 87%

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Management of adrenocortical carcinoma in Western Australia: a perspective over 14 years

Leong

Nyantoro

Shedzad

et al. 2020

ANZ Journal of Surgery

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Background Adrenocortical carcinoma is a rare but aggressive form of endocrine neoplasm that confers a poor prognosis. To date, the only Australian data published is from New South Wales. This paper describes our experience in Western Australia with a focus on surgical approach and outcomes. Methods A retrospective study of patients treated for adrenocortical carcinoma in Western Australia over 14 years was performed. Results Over the 14‐year period, a total of 33 patients underwent surgery for adrenocortical carcinoma. Resection outcomes were superior in an open en bloc approach with an 85% R0 margin (P = 0.007). Local recurrence rates were lowest in an open en bloc approach (11%) compared to laparoscopic (75%). Multivariate analysis showed that an en bloc resection is highly correlated with an R0 resection (P < 0.05) and significantly associated with lower (odds ratio = 0.06) local recurrence (P = 0.009). Higher volume surgeons (>5 cases) had lower operative times and blood loss. Compliance with mitotane was significantly improved with close monitoring of levels. The European Network for the Study of Adrenal Tumours (ENSAT) stage at presentation was most predictive of long‐term survival with 100% of stage I patients alive compared to 53% of stage II, 25% of stage III and 17% of stage IV patients at the end of the follow‐up period. Conclusion An open en bloc approach with a low threshold for multi‐visceral resection performed by high volume surgeons have improved outcomes in local recurrence, operative times and blood loss.

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Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 87%