Journal Article

Adjuvant platinum-based chemotherapy in radically resected adrenocortical carcinoma: a cohort study

Otilia Kimpel, K Mai, Mouhammed Amir Habra, Felix Megerle, Alfredo Berruti, Matthias Kroiss, Massimo Terzolo, Olaf M. Dekkers, Sara Bedrose, Martin Fassnacht

2021

Overview

Background After radical resection, patients with adrenocortical carcinoma (ACC) frequently experience recurrence and, therefore, effective adjuvant treatment is urgently needed. The aim of the study was to investigate the role of adjuvant platinum-based therapy. Methods In this retrospective multicentre cohort study, we identified patients treated with adjuvant platinum-based chemotherapy after radical resection and compared them with patients without adjuvant chemotherapy. Recurrence-free and overall survival (RFS/OS) were investigated in a matched group analysis and by applying a propensity score matching using the full control cohort ( n  = 268). For both approaches, we accounted for immortal time bias. Results Of the 31 patients in the platinum cohort (R0 n  = 25, RX n  = 4, R1 n  = 2; ENSAT Stage II n  = 11, III n  = 16, IV n  = 4, median Ki67 30%, mitotane n  = 28), 14 experienced recurrence compared to 29 of 31 matched controls (median RFS after the landmark at 3 months 17.3 vs. 7.3 months; adjusted HR 0.19 (95% CI 0.09–0.42; P  < 0.001). Using propensity score matching, the HR for RFS was 0.45 (0.29–0.89, P  = 0.021) and for OS 0.25 (0.09–0.69; P  = 0.007). Conclusions Our study provides the first evidence that adjuvant platinum-based chemotherapy may be associated with prolonged recurrence-free and overall survival in patients with ACC and a very high risk for recurrence.

• Publisher: Springer Science and Business Media LLC,Nature Publishing Group UK,Nature Publishing Group
• Subject: 631/67/1059/99 / 631/67/1459/1280 / Adolescent / Adolescent; Adrenal Cortex Neoplasms; Adrenocortical Carcinoma; Adult; Aged; Case-Control Studies; Chemotherapy, Adjuvant; Child; Child, Preschool; Female; Humans; Male; Middle Aged; Neoplasm Staging; Platinum; Propensity Score; Retrospective Studies; Survival Analysis; Treatment Outcome; Young Adult / Adrenal Cortex Neoplasms / Adrenal Cortex Neoplasms - drug therapy / Adrenal Cortex Neoplasms - pathology / Adrenal Cortex Neoplasms - surgery / Adrenal Cortex Neoplasms/pathology [MeSH] ; Aged [MeSH] ; Adrenal Cortex Neoplasms/surgery [MeSH] ; Adrenocortical Carcinoma/pathology [MeSH] ; Neoplasm Staging [MeSH] ; Platinum/administration ; Adrenal tumours ; Male [MeSH] ; Platinum/therapeutic use [MeSH] ; Case-Control Studies [MeSH] ; Propensity Score [MeSH] ; Child [MeSH] ; Adolescent [MeSH] ; Female [MeSH] ; Adult [MeSH] ; Humans [MeSH] ; Treatment Outcome [MeSH] ; Survival Analysis [MeSH] ; Retrospective Studies [MeSH] ; Middle Aged [MeSH] ; Adrenocortical Carcinoma/surgery [MeSH] ; Chemotherapy, Adjuvant [MeSH] ; Article ; Adrenocortical Carcinoma/drug therapy [MeSH] ; Young Adult [MeSH] ; Chemotherapy ; Adrenal Cortex Neoplasms/drug therapy [MeSH] ; Child, Preschool [MeSH] / Adrenocortical Carcinoma / Adrenocortical Carcinoma - drug therapy / Adrenocortical Carcinoma - pathology / Adrenocortical Carcinoma - surgery / Adult / Aged / Biomedical and Life Sciences / Biomedicine / Cancer Research / Case-Control Studies / Chemotherapy / Chemotherapy, Adjuvant / Child / Child, Preschool / Cohort analysis / ddc:610 / Drug Resistance / Epidemiology / Female / Humans / Male / Middle Aged / Molecular Medicine / Neoplasm Staging / Neuroendocrine tumors / Oncology / Patients / Platinum / Platinum - administration & dosage / Platinum - therapeutic use / Propensity Score / Retrospective Studies / Survival / Survival Analysis / Treatment Outcome / Young Adult