Resection of adrenocortical carcinoma liver metastasis: is it justified?

摘要: Adrenocortical carcinoma (ACC) liver metastases (LM) represent a therapeutic challenge, and it is unclear whether resection justified. This study assesses long-term outcome prognostic factors after for metastatic ACC. Patients who underwent of ACC LM were identified from institutional databases. Recurrence, survival, tumor characteristics, including β-catenin TP53 status based on immunohistochemistry sequencing, reviewed. The value variables was assessed with log-rank test univariate analysis Cox proportional hazard models multivariate analysis. From 1978 to 2009, 28 patients (20 females; median age, 45 years), 11 synchronous metastasis 3 extrahepatic metastasis, (major hepatectomy in 61%). Postoperative mortality nil morbidity 55%. On pathological examination, tumors multiple 68%, size 43 mm, resections R0, 1, 2 59%, 33%, 7%, respectively. All developed recurrent disease, which treated surgically 11, repeat 4. Of the 15 adequate tissue analysis, immunostaining positive 7, 4 corresponding CTNNB1 mutations associated decreased survival; p53 staining 5 (4 mutations). disease-free overall survival 7 31.5 months, respectively, 5-year 39%. In nonfunctional surgical treatment recurrence independent predictors good outcome. selected LM, is, therefore, justified but rarely curative.