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Liver Resection and Ablation for Metastatic Adrenocortical Carcinoma

  • Hepatobiliary Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Adrenocortical carcinoma (ACC) is a rare disease without effective chemotherapy treated most appropriately with resection. The aim of this study was to evaluate our experience with liver resection for metastatic ACC.

Methods

This study is a retrospective review of patients who underwent liver resection or radiofrequency ablation (RFA) for ACC from 1979 to 2009.

Results

A total of 27 patients were identified. Of the 27, 19 underwent liver resection. Of the 19, 10 had a single liver lesion, and 18 of 19 were rendered free of disease in the liver, although only 11 of 19 were rendered completely free of disease because of extrahepatic disease (EHD). Of the 19, 13 had synchronous EHD. Also, 6 of 17 remained disease free in the liver at a median follow-up of 6.2 years (status of 2 of 19 was unknown). Of the 27 patients, 8 underwent RFA, 7 of 8 became free of disease in the liver, and 5 of 7 had EHD. No patients responded to prior chemotherapy. Median overall survival and survival of patients who underwent liver resection or RFA were both 1.9 years (0.2–12 + years); 5-year actuarial survivals were 29% and 29%, respectively. Disease-free interval (DFI) greater than 9 months from primary resection was associated with longer survival (median 4.1 vs 0.9 years; P = .013).

Conclusions

This study is a tertiary institution series of liver resection and RFA for ACC. Given the lack of effective systemic treatment options and the safety of resection and ablation, liver resection or RFA may be considered in selected patients with ACC metastatic to the liver especially with a long DFI.

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Acknowledgment

Aarti Mathur, MD for assistance with data collection.

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Authors and Affiliations

  1. Surgery Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA

    R. Taylor Ripley MD, Clinton D. Kemp MD, Jeremy L. Davis MD, Russell C. Langan MD, Richard E. Royal MD, Steven K. Libutti MD, Udai S. Kammula MD & Itzhak Avital MD

  2. Biostatistics and Data Management Section, Office of the Clinical Director, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA

    Seth M. Steinberg PhD

  3. Department of Diagnostic Radiology, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA

    Bradford J. Wood MD

  4. Medicine Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA

    Tito Fojo MD, PhD

Authors
  1. R. Taylor Ripley MD
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  2. Clinton D. Kemp MD
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  3. Jeremy L. Davis MD
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  4. Russell C. Langan MD
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  6. Steven K. Libutti MD
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  8. Bradford J. Wood MD
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  9. Udai S. Kammula MD
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  11. Itzhak Avital MD
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Correspondence to R. Taylor Ripley MD.

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Ripley, R.T., Kemp, C.D., Davis, J.L. et al. Liver Resection and Ablation for Metastatic Adrenocortical Carcinoma. Ann Surg Oncol 18, 1972–1979 (2011). https://doi.org/10.1245/s10434-011-1564-z

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  • DOI: https://doi.org/10.1245/s10434-011-1564-z

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