Adrenocortical carcinoma: The University of Texas M. D. Anderson Cancer Center experience update.

Abstract

e15075 Background: Adrenocortical carcinoma is a rare aggressive malignancy. Advances in treatment and supportive care improved the outcome in patients with cancer including patients with adrenocortical carcinoma. In the past decade, there have been efforts to improve the outcome of these patients through molecular profiling to identify potential therapeutic targets. This move resulted in ongoing clinical trials to explore the efficacy of new therapeutic agents. Methods: Retrospective analysis of the clinical outcomes of patients with adrenocortical carcinoma registered at the University of Texas M. D. Anderson Cancer Center from 1998-2009 and comparison with earlier reports from our institution. Institutional review board approval was granted for this review. We summarized the patients' characteristics, survival curves, and changes in clinical management of patients seen at our institution in the past 12 years. We also reviewed treatment regimens utilized in these patients. Results: At the University of Texas M. D. Anderson Cancer Center, 287 patients have registered with adrenocortical carcinoma compared with 139 patients who were seen from 1980-1997 and reported in an earlier series. The increase in number of patients is attributed to changes in referral pattern, increased identification through increasing use of cross sectional imaging; or possibly a true increased in incidence. The 5-year survival rate was 50% (Kaplan-Meier analysis) in this series compared with 60% in the 1980-1997 series. There has been a progressive increase in the use of positron emission tomography for staging and treatment planning. Compared to earlier report, more patients were enrolled in research protocols mostly using targeted therapy in phase I trials. Detailed data about treatment will be presented in the full report. Conclusions: Adrenocortical carcinoma is a rare malignancy with high mortality rate. The recent use of targeted therapy and advanced surveillance methods have not translated yet into a major breakthrough in the management of these patients. Further concerted efforts are needed to prospectively evaluate and treat these patients through research based programs. No significant financial relationships to disclose.