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Management of adrenal cancer: a 2013 update

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Abstract

Adrenocortical carcinoma (ACC) is a devastating tumor for either patients or their families because of short life expectancy and severe impact on quality of life. Due to the rarity of ACC, with a reported annual incidence of 0.5–2 cases per million population, progress in the development of treatment options beyond surgery has been limited. Up to now, no personalized approach of ACC therapy has emerged, apart from plasma level-guided mitotane therapy, and no simple targetable molecular event has been identified from preclinical studies. Complete surgical removal of ACC is the only potentially curative approach and has the most important impact on patient’s prognosis. Despite the limits of the available evidence, adjuvant mitotane therapy is currently recommended in many expert centers whenever the patients present an elevated risk of recurrence. The management of patients with recurrent and metastatic disease is challenging and the prognosis is often poor. Mitotane monotherapy is indicated in the management of patients with a low tumor burden and/or more indolent disease while patients whose disease show an aggressive behavior need cytotoxic chemotherapy. The treatment of patients with advanced ACC may include loco-regional approaches such as surgery and radiofrequency ablation in addition to systemic therapies. The present review provides an updated overview of the management of ACC patients following surgery and of the management of ACC patients with advanced disease.

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Conflict of interest

M. Terzolo received research grants and advisory honoraria by HRA Pharma. F. Daffara, A. Ardito, B. Zaggia, V. Basile, L. Ferrari and A. Berruti declare that they have no conflict of interest.

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  1. Internal Medicine I, Department of Clinical and Biological Sciences, University of Turin, San Luigi Gonzaga Hospital, Regione Gonzole 10, 10043, Orbassano, Italy

    M. Terzolo, F. Daffara, A. Ardito, B. Zaggia & V. Basile

  2. Medical Oncology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy

    L. Ferrari & A. Berruti

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  1. M. Terzolo
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Terzolo, M., Daffara, F., Ardito, A. et al. Management of adrenal cancer: a 2013 update. J Endocrinol Invest 37, 207–217 (2014). https://doi.org/10.1007/s40618-013-0049-2

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