Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You and Your Team.

Learn More →

Treatment of Adrenal Carcinomas

Treatment of Adrenal Carcinomas Abstract • Twenty-three patients with adrenal carcinoma were treated between 1953 and 1981. Six patients underwent resection of the primary tumor and/or local radiation therapy but received no chemotherapy. Their mean survival (±SD) was 10.3±8.7 months. In contrast, 17 patients who were treated with mitotane had a mean survival of 46.6±42.7 months. Response to therapy depended on when in the course of the disease chemotherapy was instituted, and on the combination of surgical excision and drug treatment of recurrent disease. Longest survival was observed in patients who received mitotane as adjuvant therapy before clinical evidence of metastases was noted and in those who were treated with mitotane and underwent subsequent surgery for recurrent tumor. Mean survival for this group was significantly longer, 74±33 months, than for the other patients. Patients treated in this series received low-dose long-term therapy. Adverse effects of mitotane were found to be dose dependent. (Arch Surg 1982;117:1142-1146) References 1. Huvos AJ, Hajdu SI, Brosfield RD, et al: Adrenal cortical carcinoma: Clinicopathologic study of 34 cases . Cancer 1970;25:354-361.Crossref 2. Lipsett MB, Hertz R, Ross GT: Clinical and pathophysiologic aspects of adrenocortical carcinoma . Am J Med 1963;35:374-383.Crossref 3. McFarlane DA: Cancer of the adrenal cortex: The natural history, prognosis and treatment in a study of 55 cases . Ann R Coll Surg Engl 1958;23:155-186. 4. Hutter AM, Kayhoe DE: Adrenal cortical carcinoma: Clinical features of 138 patients . Am J Med 1966;41:572-580.Crossref 5. Sullivan M, Boileau M, Hodges CV: Adrenal cortical carcinoma . J Urol 1978;120:660-665. 6. Burger AR, Correa RJ: Experience with adrenal carcinoma . Urology 1977;10:12-18.Crossref 7. King DR, Lack EE: Adrenal cortical carcinoma: A clinical pathologic study of 49 cases . Cancer 1979;44:239-244.Crossref 8. Hajjar RA, Hickey RC, Samaan NA: Adrenal cortical carcinoma: A study of 22 patients . Cancer 1975;35:549-554.Crossref 9. Percarpio B, Knowlton AH: Radiation therapy of adrenal cortical carcinoma . Acta Radiol Oncol Radiat Phys Biol 1976;15:288-292.Crossref 10. Bergenstal DM, Hertz R, Lipsett MB, et al: Chemotherapy of adrenocortical cancer with op'DDD . Ann Intern Med 1980;53:672-682. 11. Hutter AM, Kayhoe DE: Adrenal cortical carcinoma: Results of treatment with op'DDD in 138 patients . Am J Med 1966;41:581-592.Crossref 12. Lubitz JA, Freeman L, Okun R: Mitotane use in inoperable adrenal cortical carcinoma . JAMA 1973;223:1109-1112.Crossref 13. Hoffman DL, Mattox VL: Treatment of adrenocortical carcinoma with op'DDD . Med Clin North Am 1972;50:999-1012. 14. Silber RH, Porter CC: The determination of 17, 21 dihydroxy 20-ketosteroids in urine and plasma . J Biol Chem 1954;210:923-932. 15. Chaney AL: Standard 17-Ketosteroids: Urine Methods of Clinical Chemistry . New York, Academic Press Inc, 1958, p 79. 16. Dash AJ, England BG, Midgley AR, et al: Specific nonchromatographic radioimmunoassay for human plasma cortisol . Steroids 1975;26:647-661.Crossref 17. Schteingart DE, Gregerman RI, Conn JW: A comparison of the characteristics of adrenocortical function in obesity and in Cushing's syndrome . Metabolism 1963;12:484-497. 18. Vague P, Oliver C, Jaquet P, et al: Le dosage radioimmunologique de l'ACTH plasmatique: Resultats chez les sujets normaux . Eur J Clin Biol Res 1971;16:485-493. 19. Niswender GD, Nett TM, Meyer DL, et al: Factors influencing the specificity of antibodies to steroid hormones , in Cameron CH, Hillier SG, Griffiths K (eds): Proceedings of the Fifth Tenovus Workshop . Cardiff, Wales, Alpha Omega Publ Ltd, 1974, p 61. 20. Buster JE, Abraham GE: Radioimmunoassay of plasma dehydroepiandrosterone . Anal Lett 1972;5:203-215.Crossref 21. Schteingart DE, Oberman HA, Friedman BA, et al: Adrenal cortical neoplasms producing Cushing's syndrome: A clinicopathologic study . Cancer 1968;22:1005-1013.Crossref 22. Lipsett MB: Adrenal carcinoma , in Charyulu KK, Sudarsanam A (eds): Hormones and Cancer . New York, Stratton Intercontinental Medical Book Corp, 1962. 23. Flint LD: Surgical exposures for adrenal endocrinopathies . Surg Clin North Am 1973;53:445-454. 24. Cahill PJ, Sukov RJ: Inferior vena caval involvement by adrenal cortical carcinoma . Urology 1977;10:604-607.Crossref 25. Greenberg PH, Marks C: Adrenal cortical carcinoma: A presentation of 22 cases and a review of the literature . Am Surg 1978;44:81-85. 26. Bradley EL: Primary and adjunctive therapy in carcinoma of the adrenal cortex . Surg Gynecol Obstet 1975;141:507-511. 27. Becker D, Schumacher OP: OP'DDD therapy in invasive adrenocortical carcinoma . Ann Intern Med 1975;82:677-679.Crossref 28. Ostuni JA, Roginsky MS: Metastatic adrenal cortical carcinoma . Arch Intern Med 1975;135:1257-1258.Crossref 29. McKierman P, Doyle DA, Towers RP, et al: OP'DDD and adrenal carcinoma . Ir J Med Sci 1978;147:437-440.Crossref 30. Downing V, Eule J, Huseby RA: Regression of an adrenal cortical carcinoma and its neovascular bed, following mitotane therapy: A case report . Cancer 1974;34:1882-1887.Crossref 31. Jarabak J, Rice K: Metastatic adrenocortical carcinoma: Prolonged regression with mitotane therapy . JAMA 1981;246:1706-1707.Crossref 32. Hogan TF, Citrin DL, Johnson BM, et al: OP'DDD (mitotane) therapy of adrenal cortical carcinoma . Cancer 1978;42:2177-2181.Crossref 33. Schteingart DE, Tsao HS, Taylor CI, et al: Sustained remission of Cushing's disease with mitotane and pituitary irradiation . Ann Intern Med 1980;92:613-619.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Loading next page...
 
/lp/american-medical-association/treatment-of-adrenal-carcinomas-B5Mz10Xvbf
Publisher
American Medical Association
Copyright
Copyright © 1982 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1982.01380330010004
Publisher site
See Article on Publisher Site

Abstract

Abstract • Twenty-three patients with adrenal carcinoma were treated between 1953 and 1981. Six patients underwent resection of the primary tumor and/or local radiation therapy but received no chemotherapy. Their mean survival (±SD) was 10.3±8.7 months. In contrast, 17 patients who were treated with mitotane had a mean survival of 46.6±42.7 months. Response to therapy depended on when in the course of the disease chemotherapy was instituted, and on the combination of surgical excision and drug treatment of recurrent disease. Longest survival was observed in patients who received mitotane as adjuvant therapy before clinical evidence of metastases was noted and in those who were treated with mitotane and underwent subsequent surgery for recurrent tumor. Mean survival for this group was significantly longer, 74±33 months, than for the other patients. Patients treated in this series received low-dose long-term therapy. Adverse effects of mitotane were found to be dose dependent. (Arch Surg 1982;117:1142-1146) References 1. Huvos AJ, Hajdu SI, Brosfield RD, et al: Adrenal cortical carcinoma: Clinicopathologic study of 34 cases . Cancer 1970;25:354-361.Crossref 2. Lipsett MB, Hertz R, Ross GT: Clinical and pathophysiologic aspects of adrenocortical carcinoma . Am J Med 1963;35:374-383.Crossref 3. McFarlane DA: Cancer of the adrenal cortex: The natural history, prognosis and treatment in a study of 55 cases . Ann R Coll Surg Engl 1958;23:155-186. 4. Hutter AM, Kayhoe DE: Adrenal cortical carcinoma: Clinical features of 138 patients . Am J Med 1966;41:572-580.Crossref 5. Sullivan M, Boileau M, Hodges CV: Adrenal cortical carcinoma . J Urol 1978;120:660-665. 6. Burger AR, Correa RJ: Experience with adrenal carcinoma . Urology 1977;10:12-18.Crossref 7. King DR, Lack EE: Adrenal cortical carcinoma: A clinical pathologic study of 49 cases . Cancer 1979;44:239-244.Crossref 8. Hajjar RA, Hickey RC, Samaan NA: Adrenal cortical carcinoma: A study of 22 patients . Cancer 1975;35:549-554.Crossref 9. Percarpio B, Knowlton AH: Radiation therapy of adrenal cortical carcinoma . Acta Radiol Oncol Radiat Phys Biol 1976;15:288-292.Crossref 10. Bergenstal DM, Hertz R, Lipsett MB, et al: Chemotherapy of adrenocortical cancer with op'DDD . Ann Intern Med 1980;53:672-682. 11. Hutter AM, Kayhoe DE: Adrenal cortical carcinoma: Results of treatment with op'DDD in 138 patients . Am J Med 1966;41:581-592.Crossref 12. Lubitz JA, Freeman L, Okun R: Mitotane use in inoperable adrenal cortical carcinoma . JAMA 1973;223:1109-1112.Crossref 13. Hoffman DL, Mattox VL: Treatment of adrenocortical carcinoma with op'DDD . Med Clin North Am 1972;50:999-1012. 14. Silber RH, Porter CC: The determination of 17, 21 dihydroxy 20-ketosteroids in urine and plasma . J Biol Chem 1954;210:923-932. 15. Chaney AL: Standard 17-Ketosteroids: Urine Methods of Clinical Chemistry . New York, Academic Press Inc, 1958, p 79. 16. Dash AJ, England BG, Midgley AR, et al: Specific nonchromatographic radioimmunoassay for human plasma cortisol . Steroids 1975;26:647-661.Crossref 17. Schteingart DE, Gregerman RI, Conn JW: A comparison of the characteristics of adrenocortical function in obesity and in Cushing's syndrome . Metabolism 1963;12:484-497. 18. Vague P, Oliver C, Jaquet P, et al: Le dosage radioimmunologique de l'ACTH plasmatique: Resultats chez les sujets normaux . Eur J Clin Biol Res 1971;16:485-493. 19. Niswender GD, Nett TM, Meyer DL, et al: Factors influencing the specificity of antibodies to steroid hormones , in Cameron CH, Hillier SG, Griffiths K (eds): Proceedings of the Fifth Tenovus Workshop . Cardiff, Wales, Alpha Omega Publ Ltd, 1974, p 61. 20. Buster JE, Abraham GE: Radioimmunoassay of plasma dehydroepiandrosterone . Anal Lett 1972;5:203-215.Crossref 21. Schteingart DE, Oberman HA, Friedman BA, et al: Adrenal cortical neoplasms producing Cushing's syndrome: A clinicopathologic study . Cancer 1968;22:1005-1013.Crossref 22. Lipsett MB: Adrenal carcinoma , in Charyulu KK, Sudarsanam A (eds): Hormones and Cancer . New York, Stratton Intercontinental Medical Book Corp, 1962. 23. Flint LD: Surgical exposures for adrenal endocrinopathies . Surg Clin North Am 1973;53:445-454. 24. Cahill PJ, Sukov RJ: Inferior vena caval involvement by adrenal cortical carcinoma . Urology 1977;10:604-607.Crossref 25. Greenberg PH, Marks C: Adrenal cortical carcinoma: A presentation of 22 cases and a review of the literature . Am Surg 1978;44:81-85. 26. Bradley EL: Primary and adjunctive therapy in carcinoma of the adrenal cortex . Surg Gynecol Obstet 1975;141:507-511. 27. Becker D, Schumacher OP: OP'DDD therapy in invasive adrenocortical carcinoma . Ann Intern Med 1975;82:677-679.Crossref 28. Ostuni JA, Roginsky MS: Metastatic adrenal cortical carcinoma . Arch Intern Med 1975;135:1257-1258.Crossref 29. McKierman P, Doyle DA, Towers RP, et al: OP'DDD and adrenal carcinoma . Ir J Med Sci 1978;147:437-440.Crossref 30. Downing V, Eule J, Huseby RA: Regression of an adrenal cortical carcinoma and its neovascular bed, following mitotane therapy: A case report . Cancer 1974;34:1882-1887.Crossref 31. Jarabak J, Rice K: Metastatic adrenocortical carcinoma: Prolonged regression with mitotane therapy . JAMA 1981;246:1706-1707.Crossref 32. Hogan TF, Citrin DL, Johnson BM, et al: OP'DDD (mitotane) therapy of adrenal cortical carcinoma . Cancer 1978;42:2177-2181.Crossref 33. Schteingart DE, Tsao HS, Taylor CI, et al: Sustained remission of Cushing's disease with mitotane and pituitary irradiation . Ann Intern Med 1980;92:613-619.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Sep 1, 1982

References