Adrenocortical carcinoma natural history: Difference between revisions

Jump to navigation Jump to search
No edit summary
 
(31 intermediate revisions by 9 users not shown)
Line 1: Line 1:
__NOTOC__
{{Adrenocortical carcinoma}}
{{Adrenocortical carcinoma}}
{{CMG}}
{{CMG}}; {{AE}} {{RT}} {{AAM}} {{MAD}}
==Prognosis==  
==Overview==
ACC, generally, carries a poor prognosis<ref name=allolio>{{cite journal | author = Allolio B, Fassnacht M | title = Clinical review: Adrenocortical carcinoma: clinical update. | journal = J Clin Endocrinol Metab | volume = 91 | issue = 6 | pages = 2027-37 | year = 2006 | id = PMID 16551738}} [http://jcem.endojournals.org/cgi/content/full/91/6/2027 Free Full Text].</ref>
If left untreated, patients with adrenocortical carcinoma may develop [[diabetes mellitus]], [[osteoporosis]], delayed [[wound healing|wound healing,]] [[hypertension]], [[Cerebrovascular disease]], and local or distant [[metastasis]]. [[Prognosis]] is generally poor, and the 5-year survival rate of patients with adrenocortical carcinoma [[Cancer staging|stage]] I-III is approximately 30%. Complications may include [[metastasis]], [[Conn's syndrome]] and [[Cushing's syndrome|Cushing'a syndrome]].
and is unlike most tumours of the adrenal cortex, which are [[benign]] ([[adenoma]]s) and only occasionally cause [[Cushing's syndrome]].  Five-year disease-free survival for a complete resection of a [[Cancer staging|stage]] I-III ACC is approximately 30%.<ref name=allolio/>
== Natural history ==
The most important '''prognostic factors''' are:
The symptoms of adrenocortical carcinoma usually develop in the fifth to sixth decade of life and start with symptoms of [[Cushing's syndrome]] such as [[weight gain]], [[acne]], [[irritability]], [[insomnia]], symptoms of [[androgen]] excess such as [[virilization]], deepening of the voice, and coarsening of the facial features.
# Age of the patient.
# Stage of the tumor.  


Poor prognostic factors:
Without treatment, the patient may develop complications such as [[diabetes mellitus]], [[osteoporosis]], [[hypertension]], [[hypercoagulable states]], [[metastasis]] to other organs, [[cardiovascular]] and [[Cerebrovascular disease|cerebrovascular diseases]].
# Mitotic activity.
 
# Venous invasion.
==Complications==
# Weight more than 50 Kg.
The following are the complications of [[Adrenocortical carcinoma]]:
# Diameter more than 6.5 cm.
* [[Cushing's syndrome]]-related complications
# Ki-67/MIB1 labeling index.
**[[Hyperglycemia]] 
**[[Diabetes mellitus]]
**[[Osteoporosis]]
**Delayed [[wound healing]]
**[[Hypertension]]
**[[Myocardial infarction]]
**[[Cerebrovascular disease]]
**[[Hypercoagulable state]]
* [[Conn's syndrome]]
* Local and distant [[metastasis]]
**[[Invasion]] of adjacent [[organs]] or [[venous]] [[extension]] into the [[renal vein]] and [[inferior vena cava]] may be present.<sup>[[Adrenocortical carcinoma pathophysiology#cite note-pmid7142516-2|[2]]]</sup>
**[[Inferior vena cava]] [[invasion]] has been reported in 9% to 19% of cases at presentation.<sup>[[Adrenocortical carcinoma pathophysiology#cite note-pmid21606258-3|[3]]]</sup>
* [[Paraneoplastic syndrome]]
* [[Tumor]] [[thrombus]] formation.
 
==Prognosis==
* Adrenocortical carcinoma, generally, carries a poor [[prognosis]].<ref name="allolio">{{cite journal | author = Allolio B, Fassnacht M | title = Clinical review: Adrenocortical carcinoma: clinical update. | journal = J Clin Endocrinol Metab | volume = 91 | issue = 6 | pages = 2027-37 | year = 2006 | id = PMID 16551738}} [http://jcem.endojournals.org/cgi/content/full/91/6/2027 Free Full Text].</ref>
* The five-year disease-free survival rate for a complete [[resection]] of a [[Cancer staging|stage]] I-III is approximately 30%.<ref name="allolio" />
* Survival ranges from a few months to several years.<ref name="pmid18505909">{{cite journal| author=Hermsen IG, Gelderblom H, Kievit J, Romijn JA, Haak HR| title=Extremely long survival in six patients despite recurrent and metastatic adrenal carcinoma. | journal=Eur J Endocrinol | year= 2008 | volume= 158 | issue= 6 | pages= 911-9 | pmid=18505909 | doi=10.1530/EJE-07-0723 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18505909  }}</ref>
'''The most important [[prognostic]] factors are:'''
* Age of the patient <ref name="pmid26392430">{{cite journal| author=Libé R, Borget I, Ronchi CL, Zaggia B, Kroiss M, Kerkhofs T et al.| title=Prognostic factors in stage III-IV adrenocortical carcinomas (ACC): an European Network for the Study of Adrenal Tumor (ENSAT) study. | journal=Ann Oncol | year= 2015 | volume= 26 | issue= 10 | pages= 2119-25 | pmid=26392430 | doi=10.1093/annonc/mdv329 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26392430  }}</ref>
* Stage of the [[tumor]] <ref name="pmid18063070">{{cite journal| author=Gonzalez RJ, Tamm EP, Ng C, Phan AT, Vassilopoulou-Sellin R, Perrier ND et al.| title=Response to mitotane predicts outcome in patients with recurrent adrenal cortical carcinoma. | journal=Surgery | year= 2007 | volume= 142 | issue= 6 | pages= 867-75; discussion 867-75 | pmid=18063070 | doi=10.1016/j.surg.2007.09.006 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18063070  }}</ref>
* [[Mitotic index|Mitotic]] activity <ref name="pmid20694732">{{cite journal| author=Miller BS, Gauger PG, Hammer GD, Giordano TJ, Doherty GM| title=Proposal for modification of the ENSAT staging system for adrenocortical carcinoma using tumor grade. | journal=Langenbecks Arch Surg | year= 2010 | volume= 395 | issue= 7 | pages= 955-61 | pmid=20694732 | doi=10.1007/s00423-010-0698-y | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20694732  }}</ref>
* Venous [[invasion]]
* Weight more than 50 Kg
* Size/Diameter more than 6.5 cm
* [[Cortisol]] production is an adverse [[Prognosis|prognostic factor]]
* [[Ki-67 (Biology)|Ki-67/]][[MIB1]] labeling index ([[antigen]] identified by [[Monoclonal antibodies|monoclonal antibody]] [[Ki-67 (Biology)|Ki-67]]).


==References==
==References==
{{reflist|2}}
{{reflist|2}}
[[Category:Endocrinology]]
[[Category:Endocrinology]]
[[Category:Types of cancer]]
[[Category:Types of cancer]]
[[Category:Oncology]]
[[Category:Disease]]
{{WikiDoc Help Menu}}
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}
{{WikiDoc Sources}}

Latest revision as of 18:51, 30 October 2017

Adrenocortical carcinoma Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Adrenocortical carcinoma from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Staging

History and Symptoms

Physical Examination

Laboratory Findings

X Ray

MRI

CT

Ultrasound

Other Imaging Studies

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Radiation Therapy

Primary prevention

Secondary prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Study

Case #1

Adrenocortical carcinoma natural history On the Web

Most recent articles

cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Adrenocortical carcinoma natural history

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Adrenocortical carcinoma natural history

CDC on Adrenocortical carcinoma natural history

Adrenocortical carcinoma natural history in the news

Blogs on Adrenocortical carcinoma natural history

Hospitals Treating Adrenocortical carcinoma

Risk calculators and risk factors for Adrenocortical carcinoma natural history

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2] Ahmad Al Maradni, M.D. [3] Mohammed Abdelwahed M.D[4]

Overview

If left untreated, patients with adrenocortical carcinoma may develop diabetes mellitus, osteoporosis, delayed wound healing, hypertension, Cerebrovascular disease, and local or distant metastasis. Prognosis is generally poor, and the 5-year survival rate of patients with adrenocortical carcinoma stage I-III is approximately 30%. Complications may include metastasis, Conn's syndrome and Cushing'a syndrome.

Natural history

The symptoms of adrenocortical carcinoma usually develop in the fifth to sixth decade of life and start with symptoms of Cushing's syndrome such as weight gain, acne, irritability, insomnia, symptoms of androgen excess such as virilization, deepening of the voice, and coarsening of the facial features.

Without treatment, the patient may develop complications such as diabetes mellitus, osteoporosis, hypertension, hypercoagulable states, metastasis to other organs, cardiovascular and cerebrovascular diseases.

Complications

The following are the complications of Adrenocortical carcinoma:

Prognosis

  • Adrenocortical carcinoma, generally, carries a poor prognosis.[1]
  • The five-year disease-free survival rate for a complete resection of a stage I-III is approximately 30%.[1]
  • Survival ranges from a few months to several years.[2]

The most important prognostic factors are:

References

  1. 1.0 1.1 Allolio B, Fassnacht M (2006). "Clinical review: Adrenocortical carcinoma: clinical update". J Clin Endocrinol Metab. 91 (6): 2027–37. PMID 16551738. Free Full Text.
  2. Hermsen IG, Gelderblom H, Kievit J, Romijn JA, Haak HR (2008). "Extremely long survival in six patients despite recurrent and metastatic adrenal carcinoma". Eur J Endocrinol. 158 (6): 911–9. doi:10.1530/EJE-07-0723. PMID 18505909.
  3. Libé R, Borget I, Ronchi CL, Zaggia B, Kroiss M, Kerkhofs T; et al. (2015). "Prognostic factors in stage III-IV adrenocortical carcinomas (ACC): an European Network for the Study of Adrenal Tumor (ENSAT) study". Ann Oncol. 26 (10): 2119–25. doi:10.1093/annonc/mdv329. PMID 26392430.
  4. Gonzalez RJ, Tamm EP, Ng C, Phan AT, Vassilopoulou-Sellin R, Perrier ND; et al. (2007). "Response to mitotane predicts outcome in patients with recurrent adrenal cortical carcinoma". Surgery. 142 (6): 867–75, discussion 867-75. doi:10.1016/j.surg.2007.09.006. PMID 18063070.
  5. Miller BS, Gauger PG, Hammer GD, Giordano TJ, Doherty GM (2010). "Proposal for modification of the ENSAT staging system for adrenocortical carcinoma using tumor grade". Langenbecks Arch Surg. 395 (7): 955–61. doi:10.1007/s00423-010-0698-y. PMID 20694732.

Template:WikiDoc Sources