Liver resection and ablation for metastatic adrenocortical carcinoma

R. Taylor Ripley, Clinton D. Kemp, Jeremy L. Davis, Russell C. Langan, Richard E. Royal, Steven K. Libutti, Seth M. Steinberg, Bradford J. Wood, Udai S. Kammula, Tito Fojo, Itzhak Avital

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Abstract

Background. Adrenocortical carcinoma (ACC) is a rare disease without effective chemotherapy treated most appropriately with resection. The aim of this study was to evaluate our experience with liver resection for metastatic ACC. Methods. This study is a retrospective review of patients who underwent liver resection or radiofrequency ablation (RFA) for ACC from 1979 to 2009. Results. A total of 27 patients were identified. Of the 27, 19 underwent liver resection. Of the 19, 10 had a single liver lesion, and 18 of 19 were rendered free of disease in the liver, although only 11 of 19 were rendered completely free of disease because of extrahepatic disease (EHD). Of the 19, 13 had synchronous EHD. Also, 6 of 17 remained disease free in the liver at a median follow-up of 6.2 years (status of 2 of 19 was unknown). Of the 27 patients, 8 underwent RFA, 7 of 8 became free of disease in the liver, and 5 of 7 had EHD. No patients responded to prior chemotherapy. Median overall survival and survival of patients who underwent liver resection or RFA were both 1.9 years (0.2-12 + years); 5-year actuarial survivals were 29% and 29%, respectively. Disease-free interval (DFI) greater than 9 months from primary resection was associated with longer survival (median 4.1 vs 0.9 years; P = .013). Conclusions. This study is a tertiary institution series of liver resection and RFA for ACC. Given the lack of effective systemic treatment options and the safety of resection and ablation, liver resection or RFA may be considered in selected patients with ACC metastatic to the liver especially with a long DFI.

Original languageEnglish (US)
Pages (from-to)1972-1979
Number of pages8
JournalAnnals of Surgical Oncology
Volume18
Issue number7
DOIs
StatePublished - Jul 2011
Externally publishedYes

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Adrenocortical Carcinoma
Liver
Survival
Liver Diseases
Drug Therapy
Rare Diseases
Safety

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Ripley, R. T., Kemp, C. D., Davis, J. L., Langan, R. C., Royal, R. E., Libutti, S. K., ... Avital, I. (2011). Liver resection and ablation for metastatic adrenocortical carcinoma. Annals of Surgical Oncology, 18(7), 1972-1979. https://doi.org/10.1245/s10434-011-1564-z

Liver resection and ablation for metastatic adrenocortical carcinoma. / Ripley, R. Taylor; Kemp, Clinton D.; Davis, Jeremy L.; Langan, Russell C.; Royal, Richard E.; Libutti, Steven K.; Steinberg, Seth M.; Wood, Bradford J.; Kammula, Udai S.; Fojo, Tito; Avital, Itzhak.

In: Annals of Surgical Oncology, Vol. 18, No. 7, 07.2011, p. 1972-1979.

Research output: Contribution to journalArticle

Ripley, RT, Kemp, CD, Davis, JL, Langan, RC, Royal, RE, Libutti, SK, Steinberg, SM, Wood, BJ, Kammula, US, Fojo, T & Avital, I 2011, 'Liver resection and ablation for metastatic adrenocortical carcinoma', Annals of Surgical Oncology, vol. 18, no. 7, pp. 1972-1979. https://doi.org/10.1245/s10434-011-1564-z
Ripley RT, Kemp CD, Davis JL, Langan RC, Royal RE, Libutti SK et al. Liver resection and ablation for metastatic adrenocortical carcinoma. Annals of Surgical Oncology. 2011 Jul;18(7):1972-1979. https://doi.org/10.1245/s10434-011-1564-z
Ripley, R. Taylor ; Kemp, Clinton D. ; Davis, Jeremy L. ; Langan, Russell C. ; Royal, Richard E. ; Libutti, Steven K. ; Steinberg, Seth M. ; Wood, Bradford J. ; Kammula, Udai S. ; Fojo, Tito ; Avital, Itzhak. / Liver resection and ablation for metastatic adrenocortical carcinoma. In: Annals of Surgical Oncology. 2011 ; Vol. 18, No. 7. pp. 1972-1979.
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title = "Liver resection and ablation for metastatic adrenocortical carcinoma",
abstract = "Background. Adrenocortical carcinoma (ACC) is a rare disease without effective chemotherapy treated most appropriately with resection. The aim of this study was to evaluate our experience with liver resection for metastatic ACC. Methods. This study is a retrospective review of patients who underwent liver resection or radiofrequency ablation (RFA) for ACC from 1979 to 2009. Results. A total of 27 patients were identified. Of the 27, 19 underwent liver resection. Of the 19, 10 had a single liver lesion, and 18 of 19 were rendered free of disease in the liver, although only 11 of 19 were rendered completely free of disease because of extrahepatic disease (EHD). Of the 19, 13 had synchronous EHD. Also, 6 of 17 remained disease free in the liver at a median follow-up of 6.2 years (status of 2 of 19 was unknown). Of the 27 patients, 8 underwent RFA, 7 of 8 became free of disease in the liver, and 5 of 7 had EHD. No patients responded to prior chemotherapy. Median overall survival and survival of patients who underwent liver resection or RFA were both 1.9 years (0.2-12 + years); 5-year actuarial survivals were 29{\%} and 29{\%}, respectively. Disease-free interval (DFI) greater than 9 months from primary resection was associated with longer survival (median 4.1 vs 0.9 years; P = .013). Conclusions. This study is a tertiary institution series of liver resection and RFA for ACC. Given the lack of effective systemic treatment options and the safety of resection and ablation, liver resection or RFA may be considered in selected patients with ACC metastatic to the liver especially with a long DFI.",
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T1 - Liver resection and ablation for metastatic adrenocortical carcinoma

AU - Ripley, R. Taylor

AU - Kemp, Clinton D.

AU - Davis, Jeremy L.

AU - Langan, Russell C.

AU - Royal, Richard E.

AU - Libutti, Steven K.

AU - Steinberg, Seth M.

AU - Wood, Bradford J.

AU - Kammula, Udai S.

AU - Fojo, Tito

AU - Avital, Itzhak

PY - 2011/7

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N2 - Background. Adrenocortical carcinoma (ACC) is a rare disease without effective chemotherapy treated most appropriately with resection. The aim of this study was to evaluate our experience with liver resection for metastatic ACC. Methods. This study is a retrospective review of patients who underwent liver resection or radiofrequency ablation (RFA) for ACC from 1979 to 2009. Results. A total of 27 patients were identified. Of the 27, 19 underwent liver resection. Of the 19, 10 had a single liver lesion, and 18 of 19 were rendered free of disease in the liver, although only 11 of 19 were rendered completely free of disease because of extrahepatic disease (EHD). Of the 19, 13 had synchronous EHD. Also, 6 of 17 remained disease free in the liver at a median follow-up of 6.2 years (status of 2 of 19 was unknown). Of the 27 patients, 8 underwent RFA, 7 of 8 became free of disease in the liver, and 5 of 7 had EHD. No patients responded to prior chemotherapy. Median overall survival and survival of patients who underwent liver resection or RFA were both 1.9 years (0.2-12 + years); 5-year actuarial survivals were 29% and 29%, respectively. Disease-free interval (DFI) greater than 9 months from primary resection was associated with longer survival (median 4.1 vs 0.9 years; P = .013). Conclusions. This study is a tertiary institution series of liver resection and RFA for ACC. Given the lack of effective systemic treatment options and the safety of resection and ablation, liver resection or RFA may be considered in selected patients with ACC metastatic to the liver especially with a long DFI.

AB - Background. Adrenocortical carcinoma (ACC) is a rare disease without effective chemotherapy treated most appropriately with resection. The aim of this study was to evaluate our experience with liver resection for metastatic ACC. Methods. This study is a retrospective review of patients who underwent liver resection or radiofrequency ablation (RFA) for ACC from 1979 to 2009. Results. A total of 27 patients were identified. Of the 27, 19 underwent liver resection. Of the 19, 10 had a single liver lesion, and 18 of 19 were rendered free of disease in the liver, although only 11 of 19 were rendered completely free of disease because of extrahepatic disease (EHD). Of the 19, 13 had synchronous EHD. Also, 6 of 17 remained disease free in the liver at a median follow-up of 6.2 years (status of 2 of 19 was unknown). Of the 27 patients, 8 underwent RFA, 7 of 8 became free of disease in the liver, and 5 of 7 had EHD. No patients responded to prior chemotherapy. Median overall survival and survival of patients who underwent liver resection or RFA were both 1.9 years (0.2-12 + years); 5-year actuarial survivals were 29% and 29%, respectively. Disease-free interval (DFI) greater than 9 months from primary resection was associated with longer survival (median 4.1 vs 0.9 years; P = .013). Conclusions. This study is a tertiary institution series of liver resection and RFA for ACC. Given the lack of effective systemic treatment options and the safety of resection and ablation, liver resection or RFA may be considered in selected patients with ACC metastatic to the liver especially with a long DFI.

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