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Background <p>Recurrent/Metastatic (R/M) ACC is aggressive with few effective treatment options. The role of surgery after chemotherapy remains unclear. Moreover, prognostic factors in R/M ACC are not well defined.</p> Methods <p>R/M ACC patients treated at Princess Margaret Cancer Centre (2002–2019) were retrospectively reviewed. Descriptive statistics were used to summarize clinical characteristics. OS was estimated by Kaplan-Meier method. Cox regression analysis was used to compute prognostic variables.</p> Results <p>Among 83 patients with metastatic ACC [36.2% de novo and 63.8% recurrent], 49 (59.0%) received systemic therapy (ST) with which 15 (30.6%) had a partial response (PR) and 8 (16.3%) had stable disease (SD). 9 (18.4%) had surgery after ST (combined therapy group); 6 (66.6%) were rendered disease free with surgery. The median OS was 26 months (20.4–40.5) for entire cohort (f/up 18 months). OS for patients having combined therapy was 31.2 months (21.4–63.3) vs 24.7 months (17.7–35.2), <i>p</i> = 0.48 for patients receiving systemic therapy alone. Being disease free after surgery was associated with better OS [39.6 (24.8-not reached), vs 23.5 months (21.4-not reached), <i>p</i> = 0.02].</p> Conclusions <p>Selected patients with R/M ACC may achieve long term survival with surgery after chemotherapy. These data highlight the potential role for multimodal therapy in managing such patients.</p>

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Role of consolidative surgery after chemotherapy in recurrent/metastatic adrenal cortical cancer (ACC): Princess Margaret Cancer Centre experience

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年8月3日

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  • Abhenil Mittal,
  • Lama Amer,
  • Olubukola Ayodele,
  • Suhaib Radi,
  • Xuan Li,
  • Daniel Vilarim Araujo,
  • Eoghan Ruadh Malone,
  • Esmail Mutahar Al-Ezzi,
  • Jesse Pasternak,
  • Ozgur Mete,
  • Di Maria Jiang,
  • Vikaash Kumar,
  • Anthony M. Joshua,
  • Shereen Ezzat,
  • Aaron Richard Hansen

摘要

Background

Recurrent/Metastatic (R/M) ACC is aggressive with few effective treatment options. The role of surgery after chemotherapy remains unclear. Moreover, prognostic factors in R/M ACC are not well defined.

Methods

R/M ACC patients treated at Princess Margaret Cancer Centre (2002–2019) were retrospectively reviewed. Descriptive statistics were used to summarize clinical characteristics. OS was estimated by Kaplan-Meier method. Cox regression analysis was used to compute prognostic variables.

Results

Among 83 patients with metastatic ACC [36.2% de novo and 63.8% recurrent], 49 (59.0%) received systemic therapy (ST) with which 15 (30.6%) had a partial response (PR) and 8 (16.3%) had stable disease (SD). 9 (18.4%) had surgery after ST (combined therapy group); 6 (66.6%) were rendered disease free with surgery. The median OS was 26 months (20.4–40.5) for entire cohort (f/up 18 months). OS for patients having combined therapy was 31.2 months (21.4–63.3) vs 24.7 months (17.7–35.2), p = 0.48 for patients receiving systemic therapy alone. Being disease free after surgery was associated with better OS [39.6 (24.8-not reached), vs 23.5 months (21.4-not reached), p = 0.02].

Conclusions

Selected patients with R/M ACC may achieve long term survival with surgery after chemotherapy. These data highlight the potential role for multimodal therapy in managing such patients.