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. 2017 Aug 4;17(1):522.
doi: 10.1186/s12885-017-3506-z.

Outcome after resection of Adrenocortical Carcinoma liver metastases: a retrospective study

Johannes Baur  1 , Tjark-Ole Büntemeyer  2 , Felix Megerle  3 , Timo Deutschbein  3 , Christine Spitzweg  4 , Marcus Quinkler  5 , Peter Nawroth  6 , Matthias Kroiss  3   7 , Christoph-Thomas Germer  2 , Martin Fassnacht  3   7 , Ulrich Steger  2 ; German Adrenocortical Carcinoma Study Group
Affiliations

Outcome after resection of Adrenocortical Carcinoma liver metastases: a retrospective study

Johannes Baur et al. BMC Cancer. .

Abstract

Background: Metastatic Adrenocortical Carcinoma (ACC) is a rare malignancy with a poor 5-year-survival rate (<15%). A surgical approach is recommended in selected patients if complete resection of distant metastasis can be achieved. To date there are only limited data on the outcome after surgical resection of hepatic metastases of ACC.

Methods: A retrospective analysis of the German Adrenocortical Carcinoma Registry was conducted. Patients with liver metastases of ACC but without extrahepatic metastases or incomplete tumour resection were included.

Results: Seventy-seven patients fulfilled these criteria. Forty-three patients underwent resection of liver metastases of ACC. Complete tumour resection (R0) could be achieved in 30 (69.8%). Median overall survival after liver resection was 76.1 months in comparison to 10.1 months in the 34 remaining patients with unresected liver metastases (p < 0.001). However, disease free survival after liver resection was only 9.1 months. Neither resection status (R0/R1) nor extent of liver resection were significant predictive factors for overall survival. Patients with a time interval to the first metastasis/recurrence (TTFR) of greater than 12 months or solitary liver metastases showed significantly prolonged survival.

Conclusions: Liver resection in the case of ACC liver metastases can achieve long term survival with a median overall survival of more than 5 years, but disease free survival is short despite metastasectomy. Time to recurrence and single versus multiple metastases are predictive factors for the outcome.

Keywords: Adrenocortical carcinoma; Liver resection; Prognosis; Retrospective study; Survival analysis.

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Conflict of interest statement

Ethics approval and consent to participate

The German Adrenocortical Carcinoma Registry was approved by the ethics committee at the University of Wuerzburg (approval number 86/03), and patients gave written informed consent before enrollment.

Consent for publication

Not applicable, as no individual patient data has been published.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flow chart of the ACC registry patients and the selection process for patients with liver metastases and no extrahepatic manifestation
Fig. 2
Fig. 2
a Overall survival (OS) after liver resection for ACC liver metastases in comparison to the non-resected group. b Disease-free survival after liver resection
Fig. 3
Fig. 3
Overall survival after liver resection of ACC liver metastases for patients with (a) 1 or more metastases, (b) time to recurrence of less or greater than 12 month, (c) R0 and R1 resection and (d) major (>2 segments) or minor liver resection
See this image and copyright information in PMC

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