TY  - JOUR
A1  - Basile, Vittoria
A1  - Puglisi, Soraya
A1  - Altieri, Barbara
A1  - Canu, Letizia
A1  - Libè, Rossella
A1  - Ceccato, Filippo
A1  - Beuschlein, Felix
A1  - Quinkler, Marcus
A1  - Calabrese, Anna
A1  - Perotti, Paola
A1  - Berchialla, Paola
A1  - Dischinger, Ulrich
A1  - Megerle, Felix
A1  - Baudin, Eric
A1  - Bourdeau, Isabelle
A1  - Lacroix, André
A1  - Loli, Paola
A1  - Berruti, Alfredo
A1  - Kastelan, Darko
A1  - Haak, Harm R.
A1  - Fassnacht, Martin
A1  - Terzolo, Massimo
T1  - What is the optimal duration of adjuvant mitotane therapy in adrenocortical carcinoma? An unanswered question
T2  - Journal of Personalized Medicine
N2  - A relevant issue on the treatment of adrenocortical carcinoma (ACC) concerns the optimal duration of adjuvant mitotane treatment. We tried to address this question, assessing whether a correlation exists between the duration of adjuvant mitotane treatment and recurrence-free survival (RFS) of patients with ACC. We conducted a multicenter retrospective analysis on 154 ACC patients treated for ≥12 months with adjuvant mitotane after radical surgery and who were free of disease at the mitotane stop. During a median follow-up of 38 months, 19 patients (12.3%) experienced recurrence. We calculated the RFS after mitotane (RFSAM), from the landmark time-point of mitotane discontinuation, to overcome immortal time bias. We found a wide variability in the duration of adjuvant mitotane treatment among different centers and also among patients cared for at the same center, reflecting heterogeneous practice. We did not find any survival advantage in patients treated for longer than 24 months. Moreover, the relationship between treatment duration and the frequency of ACC recurrence was not linear after stratifying our patients in tertiles of length of adjuvant treatment. In conclusion, the present findings do not support the concept that extending adjuvant mitotane treatment over two years is beneficial for ACC patients with low to moderate risk of recurrence.
KW  - mitotane
KW  - adjuvant treatment
KW  - adrenocortical cancer
KW  - recurrence
KW  - recurrence free survival
KW  - timing
Y1  - 2021
UR  - https://opus.bibliothek.uni-wuerzburg.de/frontdoor/index/index/docId/23650
UR  - https://nbn-resolving.org/urn:nbn:de:bvb:20-opus-236507
SN  - 2075-4426
VL  - 11
IS  - 4
ER  -