Oligometastatic adrenocortical carcinoma : the role of image-guided thermal ablation
OBJECTIVES: To evaluate the impact of image-guided ablation of liver and lung metastases from adrenocortical carcinoma (ACC).
METHODS: Patients with oligometastatic ACC (liver and lung metastases) who underwent image-guided ablation were retrospectively included in the study. Complete ablation (CA) at the first contrast-enhanced CT control, local tumor progression (LTP), local tumor progression-free survival (LTPFS), liver disease-free survival (LDFS), and overall survival (OS) were evaluated. Correlation between outcomes and other prognostic factors (including Ki67, hormonal secretion, and progression-free survival after primary tumor resection (PR-PFS)) was also analyzed. Kaplan-Meier methods, log-rank tests, and Spearman correlation models were applied.
RESULTS: Thirty-two ACC metastases (4 lung and 28 liver) from 16 patients (10 females; mean age 41 years) were treated with RFA or MWA. A single major adverse event was observed (intrahepatic hematoma with subsequent right hemothorax). One patient (2 lesions) was lost to follow-up. CA was obtained in 97% (29/30). During follow-up, LTP was registered in 7/29 cases (24.1%), with a median LTPFS of 21 months (± 12.6). Metastasis size was significantly higher in case of LTP (20 mm vs. 34.5 mm; p = 0.009) and was an independent predictive factor of local tumor control with an AUC of 0.934 (p = 0.0009). Hepatic progression was observed in 66% of the cases, with a median LDFS of 25 months. Median OS was 48.6 months. PR-PFS and hormonal secretion were independent predictors of OS (p < 0.001 and p = 0.045, respectively).
CONCLUSIONS: Image-guided ablation achieves adequate local tumor control of ACC liver and lung metastases, providing a safe and effective treatment option in the multidisciplinary management of the oligometastatic ACC.
KEY POINTS: • Image-guided ablation allows adequate local tumor control in the oligometastatic adrenocortical carcinoma setting. • After percutaneous thermal ablation, complete ablation was achieved in 29 out of 30 lesions (97%). • Lesion size together with primary resection disease-free survival and hormonal secretion play a significant role in determining outcomes.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:30 |
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| Enthalten in: |
European radiology - 30(2020), 12 vom: 03. Dez., Seite 6958-6964 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Veltri, Andrea [VerfasserIn] |
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| Links: |
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| Themen: |
Adrenocortical carcinoma |
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| Anmerkungen: |
Date Completed 15.03.2021 Date Revised 15.03.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s00330-020-07019-w |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM311989578 |
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| 100 | 1 | |a Veltri, Andrea |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Oligometastatic adrenocortical carcinoma |b the role of image-guided thermal ablation |
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| 500 | |a Date Completed 15.03.2021 | ||
| 500 | |a Date Revised 15.03.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a OBJECTIVES: To evaluate the impact of image-guided ablation of liver and lung metastases from adrenocortical carcinoma (ACC) | ||
| 520 | |a METHODS: Patients with oligometastatic ACC (liver and lung metastases) who underwent image-guided ablation were retrospectively included in the study. Complete ablation (CA) at the first contrast-enhanced CT control, local tumor progression (LTP), local tumor progression-free survival (LTPFS), liver disease-free survival (LDFS), and overall survival (OS) were evaluated. Correlation between outcomes and other prognostic factors (including Ki67, hormonal secretion, and progression-free survival after primary tumor resection (PR-PFS)) was also analyzed. Kaplan-Meier methods, log-rank tests, and Spearman correlation models were applied | ||
| 520 | |a RESULTS: Thirty-two ACC metastases (4 lung and 28 liver) from 16 patients (10 females; mean age 41 years) were treated with RFA or MWA. A single major adverse event was observed (intrahepatic hematoma with subsequent right hemothorax). One patient (2 lesions) was lost to follow-up. CA was obtained in 97% (29/30). During follow-up, LTP was registered in 7/29 cases (24.1%), with a median LTPFS of 21 months (± 12.6). Metastasis size was significantly higher in case of LTP (20 mm vs. 34.5 mm; p = 0.009) and was an independent predictive factor of local tumor control with an AUC of 0.934 (p = 0.0009). Hepatic progression was observed in 66% of the cases, with a median LDFS of 25 months. Median OS was 48.6 months. PR-PFS and hormonal secretion were independent predictors of OS (p < 0.001 and p = 0.045, respectively) | ||
| 520 | |a CONCLUSIONS: Image-guided ablation achieves adequate local tumor control of ACC liver and lung metastases, providing a safe and effective treatment option in the multidisciplinary management of the oligometastatic ACC | ||
| 520 | |a KEY POINTS: • Image-guided ablation allows adequate local tumor control in the oligometastatic adrenocortical carcinoma setting. • After percutaneous thermal ablation, complete ablation was achieved in 29 out of 30 lesions (97%). • Lesion size together with primary resection disease-free survival and hormonal secretion play a significant role in determining outcomes | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Adrenocortical carcinoma | |
| 650 | 4 | |a Interventional radiology | |
| 650 | 4 | |a Liver | |
| 650 | 4 | |a Lung | |
| 650 | 4 | |a Radiofrequency ablation | |
| 650 | 7 | |a Ki-67 Antigen |2 NLM | |
| 700 | 1 | |a Basile, Domenico |e verfasserin |4 aut | |
| 700 | 1 | |a Calandri, Marco |e verfasserin |4 aut | |
| 700 | 1 | |a Bertaggia, Chiara |e verfasserin |4 aut | |
| 700 | 1 | |a Volante, Marco |e verfasserin |4 aut | |
| 700 | 1 | |a Porpiglia, Francesco |e verfasserin |4 aut | |
| 700 | 1 | |a Calabrese, Anna |e verfasserin |4 aut | |
| 700 | 1 | |a Puglisi, Soraya |e verfasserin |4 aut | |
| 700 | 1 | |a Basile, Vittoria |e verfasserin |4 aut | |
| 700 | 1 | |a Terzolo, Massimo |e verfasserin |4 aut | |
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