Ahlman H, Jansson S, Wängberg B, Tisell L E, Scherstén T, Hansson G, Bengtsson B A, Ernest I, Jakobsson C E, Lindstedt S
Department of Surgery, Sahlgren Hospital, Göteborg, Sweden.
Eur J Surg. 1993 Mar;159(3):149-58.
To evaluate the results of treatment of a consecutive series of patients with adrenocortical carcinoma who presented during the six year period 1985 to 1991.
Open study.
Departments of Surgery, Pathology, Endocrinology, and Clinical Chemistry, Sahlgren Hospital, Göteborg, Sweden.
10 consecutive patients, two with recurrent and eight with primary adrenocortical carcinoma.
All patients were treated surgically. Two required preoperative embolisation of the tumour vessels to facilitate excision of particularly large tumours, and eight were given adjuvant treatment with mitotane (o,p'-DDD).
At a median follow up of 1.5 years (range 3 months, to 21 years) 6 patients were alive with no radiological or biochemical signs of disease; 2 were alive, but with signs of recurrence (at 3 months and 6 years, respectively); and two had died of their disease (at 4 and 8 months, respectively). For the past two years all patients have had their urinary steroid profiles monitored by gas chromatography and mass spectrometry to detect recurrence of the tumour at the earliest possible stage.
Operation is the treatment of choice for patients with adrenocortical carcinoma, particularly stages I-III. The role of mitotane as adjuvant treatment can be evaluated only in multicentre studies.
评估1985年至1991年这六年期间连续收治的肾上腺皮质癌患者的治疗结果。
开放性研究。
瑞典哥德堡萨尔格伦医院外科、病理科、内分泌科和临床化学科。
10例连续患者，其中2例为复发性肾上腺皮质癌，8例为原发性肾上腺皮质癌。
所有患者均接受手术治疗。2例患者术前需要对肿瘤血管进行栓塞，以利于切除特别大的肿瘤，8例患者接受米托坦（邻，对-滴滴滴）辅助治疗。
中位随访时间为1.5年（范围3个月至21年），6例患者存活，无疾病的影像学或生化迹象；2例存活，但有复发迹象（分别在3个月和6年时）；2例死于疾病（分别在4个月和8个月时）。在过去两年中，所有患者都通过气相色谱和质谱法监测尿类固醇谱，以便尽早发现肿瘤复发。
手术是肾上腺皮质癌患者的首选治疗方法，尤其是I-III期患者。米托坦作为辅助治疗的作用只能在多中心研究中进行评估。
