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1. Malandrino P, Al Ghuzlan A, Castaing M, Young J, Caillou B, Travagli JP, Elias D, de Baere T, Dromain C, Paci A, Chanson P, Schlumberger M, Leboulleux S, Baudin E: Prognostic markers of survival after combined mitotane- and platinum-based chemotherapy in metastatic adrenocortical carcinoma. Endocr Relat Cancer; 2010 Sep;17(3):797-807
Hazardous Substances Data Bank. MITOTANE .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Prognostic markers of survival after combined mitotane- and platinum-based chemotherapy in metastatic adrenocortical carcinoma.
  • To progress in the stratification of the first-line therapeutic management of metastatic adrenocortical carcinoma (ACC), we searched for prognostic parameters of survival in patients treated with combined mitotane- and cisplatinum-based chemotherapy as first-line.
  • We retrospectively studied prospectively collected parameters from 131 consecutive patients with metastatic ACC (44 with a tissue specimen available) treated at the Gustave Roussy Institute with mitotane- and platinum-based chemotherapy.
  • Fifty-five patients with clinical, pathological, and morphological data available together with treatment characteristics including detailed follow-up were enrolled.
  • Response was analyzed according to RECIST criteria as well as overall survival (OS) from the start of cisplatinum-based chemotherapy.
  • Using a landmark method, OS according to response to chemotherapy was analyzed.
  • Objective response to combined mitotane- and cisplatinum-based chemotherapy was 27.3%.
  • In the univariate analysis, resection of the primary, time since diagnosis, mitotane monotherapy as single first-line treatment, number of affected organs, plasma mitotane above 14 mg/l, and objective response were predictors of survival.
  • In the multivariate analysis, mitotane level > or =14 mg/l and objective response to platinum-based chemotherapy were found to be independent predictors of survival (P=0.03 and <0.001).
  • Our study suggests a prognostic role for mitotane therapy and objective response to platinum-based chemotherapy.
  • [MeSH-major] Adrenal Cortex Neoplasms / drug therapy. Adrenal Cortex Neoplasms / metabolism. Adrenocortical Carcinoma / drug therapy. Adrenocortical Carcinoma / metabolism. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Biomarkers, Tumor / metabolism
  • [MeSH-minor] Adult. Cisplatin / administration & dosage. DNA-Binding Proteins / metabolism. Endonucleases / metabolism. Female. Humans. Lymphatic Metastasis. Male. Middle Aged. Mitotane / administration & dosage. Mitotane / blood. Prognosis. Prospective Studies. Retrospective Studies. Survival Rate. Treatment Outcome

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  • (PMID = 20592067.001).
  • [ISSN] 1479-6821
  • [Journal-full-title] Endocrine-related cancer
  • [ISO-abbreviation] Endocr. Relat. Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / DNA-Binding Proteins; 78E4J5IB5J / Mitotane; EC 3.1.- / ERCC1 protein, human; EC 3.1.- / Endonucleases; Q20Q21Q62J / Cisplatin
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2. Abraham J, Bakke S, Rutt A, Meadows B, Merino M, Alexander R, Schrump D, Bartlett D, Choyke P, Robey R, Hung E, Steinberg SM, Bates S, Fojo T: A phase II trial of combination chemotherapy and surgical resection for the treatment of metastatic adrenocortical carcinoma: continuous infusion doxorubicin, vincristine, and etoposide with daily mitotane as a P-glycoprotein antagonist. Cancer; 2002 May 1;94(9):2333-43
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] A phase II trial of combination chemotherapy and surgical resection for the treatment of metastatic adrenocortical carcinoma: continuous infusion doxorubicin, vincristine, and etoposide with daily mitotane as a P-glycoprotein antagonist.
  • BACKGROUND: Adrenocortical carcinoma (ACC) is rare, nearly always fatal, and to the authors' knowledge has few nonsurgical treatment options.
  • Based on in vitro studies demonstrating the efficacy of mitotane as a P-glycoprotein (Pgp) antagonist, and expression of high levels of Pgp in ACC, the authors conducted a study of infusional doxorubicin, vincristine, and etoposide with oral mitotane +/- surgical resection in patients with metastatic ACC.
  • METHODS: Thirty-six patients with metastatic ACC received daily oral mitotane (mean, 4.6 g/day) and 96-hour infusional doxorubicin (10 mg/m(2)/day), etoposide (75 mg/m(2)/day), and vincristine (0.4 mg/m(2)/day).
  • RESULTS: Thirty-five patients were evaluable; all had metastatic disease.
  • Using a landmark method, the median survival of patients who did not respond to chemotherapy was 11.6 months from a point 4 months after the initiation of therapy, whereas that of 8 patients who demonstrated a response to chemotherapy was 34.3 months from that same landmark.
  • The predominant Grade 3/4 toxicity (according to the Common Toxicity Criteria of the National Cancer Institute) was neutropenia in 66% of cycles; however, fever occurred in only 3% of cycles.
  • CONCLUSIONS: Using a combination regimen of daily mitotane with infusional doxorubicin, vincristine, and etoposide in patients with metastatic ACC, responses were observed in 22% of patients.
  • The side effects of mitotane made treatment difficult.
  • [MeSH-major] Adrenal Cortex Neoplasms / drug therapy. Adrenal Cortex Neoplasms / surgery. Adrenocortical Carcinoma / drug therapy. Adrenocortical Carcinoma / surgery. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Mitotane / administration & dosage. P-Glycoprotein / antagonists & inhibitors
  • [MeSH-minor] Administration, Oral. Adult. Aged. Antigens, CD56 / analysis. Antineoplastic Agents, Phytogenic / administration & dosage. Combined Modality Therapy. Doxorubicin / administration & dosage. Etoposide / administration & dosage. Female. Humans. Male. Middle Aged. Neoplasm Metastasis. Rhodamines / metabolism. Survival Rate. Treatment Outcome. Vincristine / administration & dosage

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  • [Copyright] Copyright 2002 American Cancer Society.DOI 10.1002/cncr.10487
  • (PMID = 12015757.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antigens, CD56; 0 / Antineoplastic Agents, Phytogenic; 0 / P-Glycoprotein; 0 / Rhodamines; 5J49Q6B70F / Vincristine; 6PLQ3CP4P3 / Etoposide; 78E4J5IB5J / Mitotane; 80168379AG / Doxorubicin
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3. Chalasani S, Vats HS, Banerjee TK, McKenzie AK: Metastatic virilizing adrenocortical carcinoma: a rare case of cure with surgery and mitotane therapy. Clin Med Res; 2009 Jun;7(1-2):48-51
Hazardous Substances Data Bank. MITOTANE .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Metastatic virilizing adrenocortical carcinoma: a rare case of cure with surgery and mitotane therapy.
  • A 57-year-old white woman with metastases to lungs and liver from virilizing adrenocortical carcinoma (ACC) was treated with radical nephroadrenalectomy followed by oral mitotane 3 to 6 g/day for 5 months.
  • She developed complete response and remained free of disease for more than 25 years.
  • Stage I and II disease is curable with surgery.
  • Stage III and IV disease may benefit from mitotane orally with gradual adjustment of the dosage to a tolerable level.
  • Addition of chemotherapy (streptozotocin or a combination of etoposide, cisplatin and doxorubicin) to mitotane also produced responses along with increased survival among responders.
  • An international study has been started by randomizing between two of the above combinations by the Collaborative Group for Adrenocortical Carcinoma Treatment.
  • [MeSH-major] Adrenocortical Carcinoma / diagnosis. Adrenocortical Carcinoma / drug therapy. Adrenocortical Carcinoma / surgery. Antineoplastic Agents, Hormonal / therapeutic use. Mitotane / therapeutic use
  • [MeSH-minor] Combined Modality Therapy / methods. Disease-Free Survival. Female. Humans. Middle Aged. Prognosis. Remission Induction. Time Factors. Treatment Outcome

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  • [Cites] Am J Obstet Gynecol. 1995 Jun;172(6):1912-4; discussion 1914-5 [7778652.001]
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  • (PMID = 19574489.001).
  • [ISSN] 1554-6179
  • [Journal-full-title] Clinical medicine & research
  • [ISO-abbreviation] Clin Med Res
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 78E4J5IB5J / Mitotane
  • [Other-IDs] NLM/ PMC2705271
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4. Williamson SK, Lew D, Miller GJ, Balcerzak SP, Baker LH, Crawford ED: Phase II evaluation of cisplatin and etoposide followed by mitotane at disease progression in patients with locally advanced or metastatic adrenocortical carcinoma: a Southwest Oncology Group Study. Cancer; 2000 Mar 1;88(5):1159-65
Hazardous Substances Data Bank. MITOTANE .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Phase II evaluation of cisplatin and etoposide followed by mitotane at disease progression in patients with locally advanced or metastatic adrenocortical carcinoma: a Southwest Oncology Group Study.
  • BACKGROUND: A previous Southwest Oncology Group study demonstrated a 30% response rate with the combination of cisplatin and mitotane in the treatment of patients with metastatic adrenocortical carcinoma.
  • Due to the lack of data regarding the objective response rates to mitotane, the authors planned to evaluate the response rate to mitotane after disease progression on etoposide and cisplatin in patients with no prior mitotane therapy.
  • METHODS: Patients with advanced, unresectable, or metastatic adrenocortical carcinoma with objectively measurable disease or biochemical abnormalities received cisplatin, 50 mg/m(2), intravenously on Days 1 and 2, and etoposide, 100 mg/m(2), on Days 1, 2, and 3.
  • At the time of disease progression, patients who had not previously received mitotane received 1000 mg orally 4 times a day along with cortisone acetate and fludrocortisone acetate.
  • Only 16 patients with no prior mitotane therapy went on to receive mitotane at the time of disease progression.
  • CONCLUSIONS: The current study demonstrates that the combination of cisplatin and etoposide has minimal activity in advanced and metastatic adrenocortical carcinoma and other treatment strategies are warranted.
  • [MeSH-major] Adrenal Cortex Neoplasms / drug therapy. Adrenocortical Carcinoma / drug therapy. Antineoplastic Combined Chemotherapy Protocols / therapeutic use

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  • [Copyright] Copyright 2000 American Cancer Society.
  • (PMID = 10699907.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA04920; United States / NCI NIH HHS / CA / CA32102; United States / NCI NIH HHS / CA / CA38926; etc
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; 78E4J5IB5J / Mitotane; Q20Q21Q62J / Cisplatin
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5. Bartley GB, Campbell RJ, Salomão DR, Bradley EA, Marsh WR, Bite U: Adrenocortical carcinoma metastatic to the orbit. Ophthal Plast Reconstr Surg; 2001 May;17(3):215-20
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Adrenocortical carcinoma metastatic to the orbit.
  • PURPOSE: To describe the clinical course and histopathologic features of a patient with adrenocortical carcinoma metastatic to the orbit.
  • RESULTS: A 24-year-old man first came to medical attention because of symptoms referable to a 4.47-kg, nonfunctioning carcinoma of the left adrenal cortex.
  • The patient died of widespread metastatic disease 15 months after the orbital operation.
  • CONCLUSIONS: Metastasis to the orbit from adrenocortical carcinoma is rare.
  • Surgical resection is the treatment of choice, with adjunctive radiation therapy and chemotherapy in some cases.
  • [MeSH-major] Adrenal Cortex Neoplasms / pathology. Adrenocortical Carcinoma / secondary. Orbital Neoplasms / secondary
  • [MeSH-minor] Adrenalectomy. Adult. Fatal Outcome. Humans. Male. Tomography, X-Ray Computed

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  • (PMID = 11388389.001).
  • [ISSN] 0740-9303
  • [Journal-full-title] Ophthalmic plastic and reconstructive surgery
  • [ISO-abbreviation] Ophthal Plast Reconstr Surg
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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6. Ohwada S, Izumi M, Kawate S, Hamada K, Toya H, Togo N, Horiguchi J, Koibuchi Y, Takahashi T, Yamada M: Surgical outcome of stage III and IV adrenocortical carcinoma. Jpn J Clin Oncol; 2007 Feb;37(2):108-13
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Surgical outcome of stage III and IV adrenocortical carcinoma.
  • BACKGROUND: Adrenocortical carcinoma (ACC) is a rare tumor usually diagnosed at an advanced stage on invasion of or adherence to adjacent organs.
  • We report surgical outcome of stage III and IV ACCs.
  • METHODS: ACCs from seven patients at clinical stage II (n = 1), III (n = 4), or IV (n = 2) were resected.
  • RESULTS: The pathological stage was stage III in five patients and stage IV in two patients.
  • The estimated 3-year disease-free and overall survivals for stage III were 20% and 40%, respectively, with a median follow-up of 32 months (range, 11-58).
  • The 3-year disease-free and overall survivals for stage III and IV were 14.3% and 28.6%, respectively.
  • The mean disease-free survival time was 18.6 +/- 6.7 months (95% CI: 5.4-31.8).
  • The mean survival after recurrence was 19.0 +/- 3.3 months (95% CI: 12.6-25.5), and the 50% survival was 18.4 months with mitotan and cytotoxic drug therapy.
  • CONCLUSIONS: Resection for stage III, IV ACCs affords the possibility of negative margins, acceptable peri-operative morbidity and mortality, and prolongs survival in selected patients.
  • [MeSH-major] Adrenal Cortex Neoplasms / surgery. Adrenocortical Carcinoma / surgery

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  • (PMID = 17277000.001).
  • [ISSN] 1465-3621
  • [Journal-full-title] Japanese journal of clinical oncology
  • [ISO-abbreviation] Jpn. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Japan
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7. Schwarte S, Brabant EG, Bastian L, Bruns F: Cortisol as a possible marker of metastatic adrenocortical carcinoma: a case report with 3-year follow-up. Anticancer Res; 2007 Jul-Aug;27(4A):1917-20
Hazardous Substances Data Bank. MITOTANE .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Cortisol as a possible marker of metastatic adrenocortical carcinoma: a case report with 3-year follow-up.
  • BACKGROUND: Adrenocortical carcinoma (ACC) is a rare tumour, sometimes causing glucocorticoid hypersecretion.
  • Treatment guidelines have not been established, but are currently under investigation.
  • CASE REPORT: A 55-year-old Caucasian woman presented with adrenal Cushing's disease.
  • Diagnostic work-up revealed hepatic metastatic lesions of an ACC which were treated by right hemihepatectomy.
  • Treatment with mitotane (o, p'-DDD) as a cytostatic agent was not tolerated.
  • Following curettage and stabilization, radiotherapy of this region with 37.5 Gy was performed, improving slightly elevated cortisol levels and neurological symptoms.
  • An aggressive multimodal treatment, including repeated surgical approach with consolidating radiotherapy in cases of incomplete resection, might be indicated to provide symptom control and possible long-term survival in oligometastatic disease of ACC.
  • [MeSH-major] Adrenal Cortex Neoplasms / pathology. Adrenocortical Carcinoma / pathology. Biomarkers, Tumor / blood. Diagnostic Errors. Hydrocortisone / blood
  • [MeSH-minor] Adrenalectomy. Antineoplastic Agents / therapeutic use. Bone Neoplasms / radiotherapy. Bone Neoplasms / secondary. Female. Humans. Immunoassay. Liver Neoplasms / drug therapy. Liver Neoplasms / secondary. Middle Aged. Mitotane / therapeutic use. Pituitary ACTH Hypersecretion / etiology

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  • (PMID = 17649795.001).
  • [ISSN] 0250-7005
  • [Journal-full-title] Anticancer research
  • [ISO-abbreviation] Anticancer Res.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Greece
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Biomarkers, Tumor; 78E4J5IB5J / Mitotane; WI4X0X7BPJ / Hydrocortisone
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8. Nishida S, Itoh N, Sasao T, Masumori N, Taguchi K, Tsukamoto T: Adrenocortical carcinoma: retrospective study of 14 patients experienced at a single institution over 34 years. Int J Urol; 2007 Jul;14(7):581-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Adrenocortical carcinoma: retrospective study of 14 patients experienced at a single institution over 34 years.
  • OBJECTIVE: To review clinical outcome of patients with adrenocortical carcinoma experienced at a single institute over 34 years.
  • Two patients were classified as having stage II disease, seven as stage III and five as stage IV.
  • The median survival periods were 2 months in patients with stage IV and 108 months in those with stages II and III (P = 0.136).
  • Mitotane treatment in the adjuvant setting did not clearly affect the clinical courses of patients without metastasis.
  • However, the treatment was effective for metastasis that was repeatedly developed as late recurrence in one patient.
  • Three patients with metastasis at diagnosis received combination chemotherapy with etoposide, doxorubicin and cisplatin (EDP) with or without mitotane treatment, to which lung metastasis completely responded in one patient.
  • CONCLUSIONS: Adrenocortical carcinoma is a rare disease but frequently recurs.
  • The best chance of survival may be achieved by early detection and complete surgical removal.
  • There may be patients who possibly benefit from mitotane treatment with or without EDP, although this remains to be conclusively determined.
  • [MeSH-major] Adrenal Cortex Neoplasms. Adrenocortical Carcinoma
  • [MeSH-minor] Adult. Aged. Child, Preschool. Female. Humans. Male. Middle Aged. Retrospective Studies. Time Factors

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  • (PMID = 17645596.001).
  • [ISSN] 0919-8172
  • [Journal-full-title] International journal of urology : official journal of the Japanese Urological Association
  • [ISO-abbreviation] Int. J. Urol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Australia
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9. Baudin E, Docao C, Gicquel C, Vassal G, Bachelot A, Penfornis A, Schlumberger M: Use of a topoisomerase I inhibitor (irinotecan, CPT-11) in metastatic adrenocortical carcinoma. Ann Oncol; 2002 Nov;13(11):1806-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Use of a topoisomerase I inhibitor (irinotecan, CPT-11) in metastatic adrenocortical carcinoma.
  • BACKGROUND: Complete responses are rare after medical treatment of adrenocortical tumors.
  • We performed a single center prospective study of the antitumor effect of irinotecan (CPT-11) in patients with metastatic adrenocortical cancer.
  • PATIENTS AND METHODS: Since 1999, all patients with advanced progressive adrenocortical carcinoma, referred to the Institut Gustave-Roussy, have been enrolled prospectively in this study.
  • RESULTS: During treatment, no dose or schedule modifications were made.
  • A median of three courses were given (range 1-8), and all but two patients received at least three complete chemotherapy courses.
  • CONCLUSIONS: Our results do not support a major role of CPT-11 in adrenocortical carcinoma.

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  • (PMID = 12419755.001).
  • [ISSN] 0923-7534
  • [Journal-full-title] Annals of oncology : official journal of the European Society for Medical Oncology
  • [ISO-abbreviation] Ann. Oncol.
  • [Language] ENG
  • [Publication-type] Clinical Trial; Comparative Study; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 7673326042 / irinotecan; XT3Z54Z28A / Camptothecin
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10. Allolio B, Hahner S, Weismann D, Fassnacht M: Management of adrenocortical carcinoma. Clin Endocrinol (Oxf); 2004 Mar;60(3):273-87
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Management of adrenocortical carcinoma.
  • Adrenocortical carcinoma (ACC) is a rare neoplasm with poor prognosis.
  • In addition, computed tomography (CT) typically demonstrates an inhomogeneous adrenal lesion with irregular margins and variable enhancement of solid components after intravenous contrast media.
  • Complete tumour removal (R0 resection) offers by far the best chance for long-term survival and therefore surgery is the treatment of choice in stage I-III ACC.
  • Thus adjuvant treatment options need to be evaluated in high-risk patients (e.g. radiation therapy of the tumour bed and/or chemotherapy).
  • In metastatic disease (stage IV ACC) not amenable to surgery mitotane (o,p'DDD) remains the first-line therapy.
  • Drug monitoring is needed for effective treatment aiming at concentrations between 14 and 20 mg/l.
  • Patients not responding to mitotane may benefit from cytotoxic chemotherapy (23% partial remissions, 4% complete remissions).
  • Only large prospective multicentre trials comparing different treatment options will allow to make systematic progress in the management of ACC.
  • [MeSH-major] Adrenal Cortex Neoplasms / therapy. Carcinoma / therapy
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Cytokines / therapeutic use. Humans. Magnetic Resonance Imaging. Neoplasm Staging. Prognosis. Tomography, X-Ray Computed

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  • (PMID = 15008991.001).
  • [ISSN] 0300-0664
  • [Journal-full-title] Clinical endocrinology
  • [ISO-abbreviation] Clin. Endocrinol. (Oxf)
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Cytokines
  • [Number-of-references] 154
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11. Tucci S Jr, Martins AC, Suaid HJ, Cologna AJ, Reis RB: The impact of tumor stage on prognosis in children with adrenocortical carcinoma. J Urol; 2005 Dec;174(6):2338-42, discussion 2342
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The impact of tumor stage on prognosis in children with adrenocortical carcinoma.
  • PURPOSE: We evaluated treatment outcomes in children with adrenocortical carcinoma.
  • Children with incomplete excision of the tumor and/or stage IV disease received adjuvant chemotherapy.
  • RESULTS: Ultrasonography, computerized tomography and magnetic resonance imaging exhibited specificity of 100% in the diagnosis of vascular invasion, and sensitivity of 50%, 66% and 100%, respectively.
  • Patient age, tumor stage or size and vascular invasion were associated with survival in univariate analysis.
  • Tumor stage was the only independent factor associated with survival in multivariate analysis.
  • The overall 5-year survival rates according to tumor stage were 100% in stage I, 85% in stage II, 40% in stage III and 0% in stage IV.
  • A total of 10 children with stage IV disease treated with chemotherapy died within a median of 6 months.
  • CONCLUSIONS: Tumor stage was the most relevant prognostic factor for children with adrenocortical carcinoma.
  • [MeSH-major] Adrenal Cortex Neoplasms / diagnosis. Adrenocortical Carcinoma / diagnosis
  • [MeSH-minor] Adolescent. Cardiopulmonary Bypass. Child. Child, Preschool. Female. Follow-Up Studies. Humans. Infant. Magnetic Resonance Imaging. Male. Multivariate Analysis. Neoplasm Invasiveness. Neoplasm Recurrence, Local / epidemiology. Neoplasm Recurrence, Local / etiology. Neoplasm Staging. Prognosis. Retrospective Studies. Sensitivity and Specificity. Survival Analysis. Thrombectomy. Tomography, X-Ray Computed. Treatment Outcome

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  • (PMID = 16280838.001).
  • [ISSN] 0022-5347
  • [Journal-full-title] The Journal of urology
  • [ISO-abbreviation] J. Urol.
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] United States
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12. Langer P, Bartsch D, Moebius E, Rothmund M, Nies C: Adrenocortical carcinoma--our experience with 11 cases. Langenbecks Arch Surg; 2000 Oct;385(6):393-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Adrenocortical carcinoma--our experience with 11 cases.
  • BACKGROUND AND AIMS: Adrenocortical carcinoma (ACC) is a rare tumour with an incidence of approximately 0.5-2 cases per million per year.
  • PATIENTS/METHODS: The data of the patients with ACC were reviewed and presenting symptoms, diagnostic procedures, treatment and results of follow-up were evaluated.
  • At the time of diagnosis, five tumours were classified as stage II, two as stage III and four as stage IV.
  • Five patients received additional chemotherapy.
  • Five of the 11 patients are still alive (three stage II, one stage III and one stage IV at the time of diagnosis), three of whom have no evidence of disease (14, 48 and 71 months after surgery).
  • There is no consensus concerning adjuvant therapy.

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  • (PMID = 11127523.001).
  • [ISSN] 1435-2443
  • [Journal-full-title] Langenbeck's archives of surgery
  • [ISO-abbreviation] Langenbecks Arch Surg
  • [Language] ENG
  • [Publication-type] Journal Article
  • [Publication-country] Germany
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13. Hanna AM, Pham TH, Askegard-Giesmann JR, Grams JM, Iqbal CW, Stavlo P, Moir CR: Outcome of adrenocortical tumors in children. J Pediatr Surg; 2008 May;43(5):843-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Outcome of adrenocortical tumors in children.
  • PURPOSE: This study reviews adrenocortical tumors in children to determine factors that significantly affect outcome.
  • METHODS: An institutional review board-approved retrospective review from 1976 to 2005 identified 23 patients younger than 19 years old with histologic confirmation of adrenocortical carcinoma (ACC) and adenomas.
  • RESULTS: The mean age of the 23 children was 9.0 +/- 1.6 years; girls predominated (female-to-male ratio = 1.9:1) as did cancers (ACC 16, adenoma 7); tumor hormone production (74%); and advanced stage for disease (66%).
  • Three patients received chemotherapy or chemoradiation as primary treatment without surgery.
  • Surgical cure without adjuvant therapy was achieved for all adenomas and ACC stages I and II.
  • For ACC stage III and IV, median survival was 21 months, 5-year survival was 0%.
  • All advanced-staged ACC received adjuvant therapy.
  • The high percentage of children with functioning tumors suggests earlier detection is possible.
  • [MeSH-major] Adenoma / mortality. Adenoma / surgery. Adrenal Cortex Neoplasms / mortality. Adrenal Cortex Neoplasms / surgery. Adrenocortical Carcinoma / mortality. Adrenocortical Carcinoma / surgery
  • [MeSH-minor] Adolescent. Adrenalectomy. Chemotherapy, Adjuvant. Child. Child, Preschool. Female. Humans. Infant. Infant, Newborn. Male. Neoplasm Staging. Radiotherapy, Adjuvant. Retrospective Studies. Survival Rate. Treatment Outcome

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  • (PMID = 18485950.001).
  • [ISSN] 1531-5037
  • [Journal-full-title] Journal of pediatric surgery
  • [ISO-abbreviation] J. Pediatr. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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14. Lee JO, Lee KW, Kim CJ, Kim YJ, Lee HE, Kim H, Kim JH, Bang SM, Kim JS, Lee JS: Metastatic adrenocortical carcinoma treated with sunitinib: a case report. Jpn J Clin Oncol; 2009 Mar;39(3):183-5
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Metastatic adrenocortical carcinoma treated with sunitinib: a case report.
  • Adrenocortical carcinoma (ACC) is a rare malignancy with poor prognosis.
  • Palliative chemotherapy can be considered in patients with metastatic disease.
  • Although mitotane- or cisplatin-based chemotherapy regimens are widely used, the effects of these agents have been limited.
  • We have experienced a case that showed a partial response with sunitinib after failure of mitotane-based cytotoxic chemotherapy.
  • To our knowledge, this is the first reported case showing the effects of sunitinib on metastatic ACC.
  • [MeSH-major] Adrenal Cortex Neoplasms / drug therapy. Adrenal Cortex Neoplasms / pathology. Antineoplastic Agents / therapeutic use. Carcinoma / drug therapy. Carcinoma / secondary. Indoles / therapeutic use. Pyrroles / therapeutic use
  • [MeSH-minor] Angiogenesis Inhibitors / therapeutic use. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Drug Resistance, Neoplasm. Humans. Male. Mitotane / administration & dosage. Radiotherapy, Adjuvant. Treatment Failure. Treatment Outcome. Young Adult

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  • (PMID = 19168875.001).
  • [ISSN] 1465-3621
  • [Journal-full-title] Japanese journal of clinical oncology
  • [ISO-abbreviation] Jpn. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Angiogenesis Inhibitors; 0 / Antineoplastic Agents; 0 / Indoles; 0 / Pyrroles; 0 / sunitinib; 78E4J5IB5J / Mitotane
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15. Kendrick ML, Lloyd R, Erickson L, Farley DR, Grant CS, Thompson GB, Rowland C, Young WF Jr, van Heerden JA: Adrenocortical carcinoma: surgical progress or status quo? Arch Surg; 2001 May;136(5):543-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Adrenocortical carcinoma: surgical progress or status quo?
  • HYPOTHESIS: Outcome of patients with adrenocortical carcinoma (ACC) has improved with the advent of more widely available and higher quality imaging.
  • Operative management strategies and use of adjuvant therapy have not changed.
  • DESIGN: Retrospective review of patient histories, imaging studies, operative data, adjuvant therapy, and outcomes at a single institution.
  • MAIN OUTCOME MEASURES: Determinants of recurrence, survival, and the effect of adjuvant therapy on overall outcome.
  • Stage according to the TNM staging system (AJCC Cancer Staging Manual) at presentation was I (n = 0), II (n = 30), III (n = 7), and IV (n = 21).
  • Recurrence occurred in 30 patients (73%) with a median time to recurrence of 17 months.
  • Prognostic factors (P<.05) included functional status, stage, and chemotherapy in stage III/IV patients.
  • (1) Surgical resection remains the principal treatment for stage I to III disease. (2) Adjuvant therapy may improve survival in patients with stage III or IV disease. (3) Current patients were more likely to present at an earlier stage, undergo curative resections, and have improved 5-year survival than institutional historical comparisons.
  • [MeSH-major] Adrenal Cortex Neoplasms / surgery

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  • (PMID = 11343545.001).
  • [ISSN] 0004-0010
  • [Journal-full-title] Archives of surgery (Chicago, Ill. : 1960)
  • [ISO-abbreviation] Arch Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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16. Ilias I, Alevizaki M, Philippou G, Anastasiou E, Souvatzoglou A: Sustained remission of metastatic adrenal carcinoma during long-term administration of low-dose mitotane. J Endocrinol Invest; 2001 Jul-Aug;24(7):532-5
Hazardous Substances Data Bank. MITOTANE .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Sustained remission of metastatic adrenal carcinoma during long-term administration of low-dose mitotane.
  • We present our experience with two female patients suffering from metastatic, recurrent adrenocortical carcinomas, to whom o,p'-DDD (mitotane) was administered for unusually long duration.
  • The second patient presented with metastatic disease and underwent radical surgical excision of the adrenal.
  • Both patients tolerated the medication well, regardless of the daily dosage, with complaints limited to epigastric pain and nausea, while their disease has been kept under control for 14 and 16 yr, respectively.
  • The blockade of steroid synthesis with mitotane resulted in hypercholesterolemia in both patients and in premature menopause in the second patient; however, these abnormalities were taken care of with the appropriate therapy.
  • The excellent follow-up of these patients suggests that even in hopeless cases with metastatic adrenocortical carcinoma, mitotane should be administered for very long periods of time as it can be well-tolerated and may be beneficial in the long run.
  • [MeSH-major] Adrenal Gland Neoplasms / drug therapy. Antineoplastic Agents, Hormonal / therapeutic use. Carcinoma / drug therapy. Mitotane / therapeutic use
  • [MeSH-minor] Adult. Cushing Syndrome / drug therapy. Female. Humans. Tomography, X-Ray Computed. Treatment Outcome

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  • (PMID = 11508789.001).
  • [ISSN] 0391-4097
  • [Journal-full-title] Journal of endocrinological investigation
  • [ISO-abbreviation] J. Endocrinol. Invest.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Italy
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17. Soga H, Takenaka A, Ooba T, Nakano Y, Miyake H, Takeda M, Tanaka K, Hara I, Fujisawa M: A twelve-year experience with adrenal cortical carcinoma in a single institution: long-term survival after surgical treatment and transcatheter arterial embolization. Urol Int; 2009;82(2):222-6

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] A twelve-year experience with adrenal cortical carcinoma in a single institution: long-term survival after surgical treatment and transcatheter arterial embolization.
  • INTRODUCTION: We retrospectively analyzed 6 cases of adrenal cortical carcinoma (ACC) treated during a 12-year period at a single institution.
  • Three patients were clinically classified as stage II, 2 as stage III and 1 as stage IV with bone metastasis.
  • Two patients without reoperation for metastases died, and others with radical treatments such as surgery, chemotherapy, transcatheter arterial embolization and/or radiation remain alive.
  • [MeSH-major] Adrenal Cortex Neoplasms / therapy. Adrenalectomy. Adrenocortical Carcinoma / therapy. Chemoembolization, Therapeutic
  • [MeSH-minor] Adult. Aged. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bone Neoplasms / secondary. Bone Neoplasms / therapy. Female. Humans. Japan. Liver Neoplasms / secondary. Liver Neoplasms / therapy. Male. Middle Aged. Neoplasm Staging. Reoperation. Retrospective Studies. Survival Analysis. Time Factors. Tomography, X-Ray Computed. Treatment Outcome

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  • [Copyright] Copyright 2009 S. Karger AG, Basel.
  • (PMID = 19322014.001).
  • [ISSN] 1423-0399
  • [Journal-full-title] Urologia internationalis
  • [ISO-abbreviation] Urol. Int.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Switzerland
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18. Tauchmanovà L, Colao A, Marzano LA, Sparano L, Camera L, Rossi A, Palmieri G, Marzano E, Salvatore M, Pettinato G, Lombardi G, Rossi R: Andrenocortical carcinomas: twelve-year prospective experience. World J Surg; 2004 Sep;28(9):896-903

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Adrenocortical carcinoma (AC) is a rare tumor with poor prognosis.
  • Twenty-two patients (14 F, 8 M; age 22 to 59 years; median, 43 years) with AC were evaluated prospectively in a single center: tumor stage was I-II in 12 cases and III-IV in 10.
  • At diagnosis, 14 patients (63.5%) presented with features of clear adrenocortical hyperactivity.
  • The most common clinical finding was a recent diagnosis of moderate-to-severe hypertension (68%), poorly controlled by pharmacological treatment, often associated with multiple cardiovascular risk factors.
  • Response to treatments other than surgery (mitotane chemotherapy) was better in patients treated early after the first surgery.
  • In conclusion, curative surgery was the most effective treatment.
  • Monitoring arterial pressure, endocrine parameters, and metabolic parameters can be helpful for the early detection of AC recurrences.
  • [MeSH-major] Adrenal Cortex Neoplasms / surgery. Adrenocortical Carcinoma / surgery
  • [MeSH-minor] Adult. Female. Humans. Male. Middle Aged. Prospective Studies. Time Factors. Treatment Outcome

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  • (PMID = 15593464.001).
  • [ISSN] 0364-2313
  • [Journal-full-title] World journal of surgery
  • [ISO-abbreviation] World J Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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19. Shon Ch, Mladenovski V, Petkov R, K'tev N, Mikhailov N, Gavrailov M, Trifonov D: [Diagnosis and surgical treatment of adrenocortical carcinoma. A review of the literature and report of two cases]. Khirurgiia (Sofiia); 2000;56(2):45-9
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Diagnosis and surgical treatment of adrenocortical carcinoma. A review of the literature and report of two cases].
  • Adrenocortical carcinomas (ACC) are rare and represent only 0.05 to 0.2% of all cancers.
  • Commonly most of the cases with AC are diagnosed when the neoplastic process have spread out of the suprarenal gland (stage III or IV).
  • Computed tomography and magnetic resonance imaging are the most useful diagnostic methods of ACC but the latter is more accurate, especially in estimation of the local invasion of the tumor.
  • Surgery is the main and the most effective method for treatment of both primary and recurrent ACC, and in selective cases--of metastasis.
  • The chemotherapy with mitotane has a limited role and is indicated in cases of inoperable ACC (primary or recurrent) and/or presence of metastasis.
  • Case I: a 26-years-old female with ACC in stage II, which was diagnosed incidentally by ultrasound investigation for other consideration.
  • Problems in diagnose and surgical treatment of these cases are discussed.
  • [MeSH-major] Adrenal Cortex Neoplasms / diagnosis. Adrenal Cortex Neoplasms / surgery. Adrenocortical Carcinoma / diagnosis. Adrenocortical Carcinoma / surgery
  • [MeSH-minor] Adult. Female. Humans. Magnetic Resonance Imaging. Middle Aged. Tomography, X-Ray Computed. Treatment Outcome. Ultrasonography

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  • (PMID = 11484289.001).
  • [ISSN] 0450-2167
  • [Journal-full-title] Khirurgii︠a︡
  • [ISO-abbreviation] Khirurgiia (Sofiia)
  • [Language] bul
  • [Publication-type] Case Reports; English Abstract; Journal Article; Review
  • [Publication-country] Bulgaria
  • [Number-of-references] 41
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20. Xiao ZJ, Li CL: [Combined therapy of advanced adrenal cortical adenocarcinoma]. Zhonghua Yi Xue Za Zhi; 2010 Aug 10;90(30):2123-5

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Combined therapy of advanced adrenal cortical adenocarcinoma].
  • OBJECTIVE: To analyze the clinical efficacy of combined therapy in the treatment of advanced adrenal cortical adenocarcinoma.
  • METHODS: The clinical data of 12 cases with advanced adrenal cortical adenocarcinoma at our hospital from 1986 - 2006 were analyzed.
  • All cases were treated with chemotherapy or chemotherapy pulse post-operative radiotherapy.
  • Pathological diagnosis was all of adrenal cortical adenocarcinoma.
  • According to the staging criteria of Jacques and Brennan, all 12 cases were of IV stage.
  • The median survival time was 14 months and median progression-free survival time 9 months.
  • CONCLUSION: Combined therapy of adrenal cortical adenocarcinoma is effective to prolong the patient lifespan.
  • Making an early diagnosis and offering a novel therapy yield a better outcome.
  • [MeSH-major] Adrenal Cortex Neoplasms / pathology. Adrenal Cortex Neoplasms / therapy. Adrenocortical Carcinoma / pathology. Adrenocortical Carcinoma / therapy
  • [MeSH-minor] Adult. Combined Modality Therapy. Female. Humans. Male. Middle Aged. Neoplasm Staging. Retrospective Studies. Treatment Outcome

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  • (PMID = 21029628.001).
  • [ISSN] 0376-2491
  • [Journal-full-title] Zhonghua yi xue za zhi
  • [ISO-abbreviation] Zhonghua Yi Xue Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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