Long-term survival after complete resection and repeat resection in patients with adrenocortical carcinoma
Long-term survival after complete resection and repeat resection in patients with adrenocortical carcinoma
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DOI：
10.1007/s10434-999-0719-7
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发表时间：
1999-12-01
影响因子：
3.7
通讯作者：
Brennan, MF
中科院分区：
文献类型：
--
作者：
Schulick, RD;Brennan, MF
背景资料：肾上腺皮质癌治疗中的关键问题之一是对受影响患者的局部复发和转移性疾病进行重复切除的疗效。在治疗局部复发或转移性疾病的选择是有限的，因为化疗和放疗一般不提供任何显着延长生存期治疗patients.Methods：一系列的113例患者谁提出纪念斯隆-凯特琳癌症中心治疗肾上腺皮质癌。所有113例患者的中位总生存期为38个月（5年生存率为37%）。早期I或II期疾病患者（n = 57）的中位生存期为101个月（5年生存率，60%），而晚期III或IV期疾病患者（n = 56）的中位生存期为15个月（5年生存率，10%）。完全切除的患者（n = 68）中位生存期为74个月（5年生存率，55%），而不完全切除的患者（n = 45）中位生存期为12个月（5年生存率，5%）。在这些患者中，47例进行了局部复发或远处转移性疾病的切除术。第二次完全切除的患者中位生存期为74个月（5年生存率为57%），而第二次不完全切除的患者中位生存期为16个月（5年生存率为0%）。局部复发或远处转移的患者接受完全重复切除术也提高了生存率。完全重复切除术更容易实现离散的远处转移病灶相比，巨大的局部复发。
Background: One of the key issues in the treatment of adrenocortical carcinoma is the efficacy of repeat resection of local recurrence and metastatic disease in affected patients. Options in the treatment of locally recurrent or metastatic disease are limited because chemotherapy and radiotherapy generally do not provide any significant prolongation in survival in treated patients.Methods: A series of 113 patients who presented to Memorial Sloan-Kettering Cancer Center for treatment of adrenocortical carcinoma are presented.Results: The median overall survival for all 113 patients was 38 months (5-year survival, 37%). Patients presenting with early stage I or II disease (n = 57) had a median survival of 101 months (5-year survival, 60%), whereas those with late stage III or IV disease (n = 56) had a median survival of 15 months (5-year survival, 10%). Patients who had complete primary resection (n = 68) had a median survival of 74 months (5-year survival, 55%), whereas those with incomplete primary resection (n = 45) had a median survival of 12 months (5-year survival, 5%). Resection of locally recurrent or distant metastatic disease was performed in 47 of these patients. Patients who had a complete second resection had a median survival of 74 months (5-year survival, 57%), whereas those with incomplete second resection had a median survival of 16 months (5-year survival, 0%).Conclusions: Improved survival is seen in patients who present with early stage and have complete primary resection. Patients who undergo complete repeat resection of local recurrence or distant metastasis also have improved survival. Complete repeat resection was more readily accomplished in discrete distant metastatic lesions compared with bulky local recurrences.