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Vol. 15, Art. 59 (pp. 742-754)    |    2014       

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Combined treatment of locally advanced adrenocortical cancer

N.A. Maystrenko1 , P.N. Romaschenko1 , R.V. Orlova2 , A.I. Babich1

Military-Medical Academy. CM. Kirova1, FGBVOU VPO "Military Medical Academy. CM. Kirov "
Saint Petersburg State University, St. Petersburg State University Faculty of Medicine

Brief summary

The results of examination and treatment of 96 patients with adrenocortical cancer have been analyzed. 51 patients was on III stage of disease (T1-4N1M0; T3-4N0M0 classification ENSAT). All patients (on III stage) were operate with open access. The surgical procedure include removing the adrenal gland with perirenal and fiber package of regional lymph nodes in 28 patients AKP, removing of the right adrenal gland and thrombus of the inferior vena cava - in 2 patients, adrenalectomy and nephrectomy - in 19. The majority of patients (52.2%) on stage III, who underwent only surgical treatment (control group), died at 1 year after surgery from disease progression. In the main group patients receiving surgical treatment and neoadjuvant chemotherapy on the basis of platinum-including agent and taxanes, the peak of mortality was observed after 2 years after surgery. One-year survival rate for patients in the control and main group comprised 47.8% and 96.4%, respectively, 2-year - 8.7% and 46.4%, 3-year - 4.4% and 32.2%, 4-year - 4.4% and 10.7%. The overall 5-year survival for both groups was 0%. It was found that the combined treatment of patients with locally advanced forms of adrenocortical cancer in the amount of adrenalectomy with the removal of retroperitoneal fat and conduct of chemotherapy, provides an increase in the duration of disease-free interval and overall survival.


Key words

adrenocortical carcinoma, adrenalectomy, adrenocortical cancer chemotherapy, combined treatment of adrenocortical cancer.

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