{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T02:37:59Z","timestamp":1772851079711,"version":"3.50.1"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2023,1,10]],"date-time":"2023-01-10T00:00:00Z","timestamp":1673308800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,4,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Adrenocortical carcinoma is an aggressive tumor which often recurs despite apparent complete resection. This study assessed the long-term outcomes for patients with recurrent adrenocortical carcinoma after multimodal salvage therapy with chemotherapy, chemoradiotherapy and surgery.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We retrospectively reviewed medical records of patients who had a pathological diagnosis of adrenocortical carcinoma between 1996 and 2017. Kaplan\u2013Meier curves were used to assess progression-free and cancer-specific survivals among all patients and cancer-specific survival among patients with tumor recurrence. Log-rank test was used to compare patient survivals by modality of salvage therapy (chemotherapy, chemoradiotherapy and chemotherapy\/chemoradiotherapy plus surgery).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 20 patients who underwent initial surgery, recurrence occurred in 14 (70%) with a median interval of 7.5 (range 1.0\u201312.6) months. Salvage therapy provided was chemotherapy only (n = 7), chemoradiotherapy (n = 2) and chemotherapy\/chemoradiotherapy plus surgery (n = 5). Of the five patients who received salvage surgery, three underwent repeated resections. The potential benefit of multimodal salvage therapy was suggested in five patients (4 with chemotherapy\/chemoradiotherapy plus surgery and 1 with chemoradiotherapy) who achieved durable disease control (cancer-specific survival from initial recurrence, 22\u2013258 months). With a median follow-up of 25 months from recurrence, the 5-year cancer-specific survival rate was 58%. cancer-specific survival after recurrence was prolonged in patients with \u2264 stage 3 disease, positive response to chemotherapy\/chemoradiotherapy and salvage surgery.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Long-term disease control and survival could be achieved in highly selected patients with recurrent adrenocortical carcinoma using a multidisciplinary approach. Patients who had relatively limited recurrent sites and responded well to chemotherapy\/chemoradiotherapy may be considered for salvage surgery on a case-by-case basis.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jjco\/hyac207","type":"journal-article","created":{"date-parts":[[2023,1,11]],"date-time":"2023-01-11T16:52:12Z","timestamp":1673455932000},"page":"436-442","source":"Crossref","is-referenced-by-count":1,"title":["The role of multimodal salvage therapy in the management of recurrent adrenocortical carcinoma"],"prefix":"10.1093","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4380-9294","authenticated-orcid":false,"given":"Toshiki","family":"Kijima","sequence":"first","affiliation":[{"name":"Tokyo Medical and Dental University Department of Urology, , Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shohei","family":"Fukuda","sequence":"additional","affiliation":[{"name":"Tokyo Medical and Dental University Department of Urology, , Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Fukushima","sequence":"additional","affiliation":[{"name":"Tokyo Medical and Dental University Department of Urology, , Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sho","family":"Uehara","sequence":"additional","affiliation":[{"name":"Tokyo Medical and Dental University Department of Urology, , Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yosuke","family":"Yasuda","sequence":"additional","affiliation":[{"name":"Tokyo Medical and Dental University Department of Urology, , Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soichiro","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Tokyo Medical and Dental University Department of Urology, , Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minato","family":"Yokoyama","sequence":"additional","affiliation":[{"name":"Tokyo Medical and Dental University Department of Urology, , Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoh","family":"Matsuoka","sequence":"additional","affiliation":[{"name":"Tokyo Medical and Dental University Department of Urology, , Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazutaka","family":"Saito","sequence":"additional","affiliation":[{"name":"Tokyo Medical and Dental University Department of Urology, , Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuhisa","family":"Fujii","sequence":"additional","affiliation":[{"name":"Tokyo Medical and Dental University Department of Urology, , Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,1,10]]},"reference":[{"key":"2023050106125694600_ref1","doi-asserted-by":"crossref","first-page":"872","DOI":"10.1007\/s00268-005-0329-x","article-title":"Extent of disease at presentation and outcome for adrenocortical carcinoma: have we made progress?","volume":"30","author":"Kebebew","year":"2006","journal-title":"World J Surg"},{"key":"2023050106125694600_ref2","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1038\/nrendo.2010.235","article-title":"Adrenocortical carcinoma: a clinician's update","volume":"7","author":"Fassnacht","year":"2011","journal-title":"Nat Rev Endocrinol"},{"key":"2023050106125694600_ref3","first-page":"963","article-title":"An eleven-year experience with adrenocortical carcinoma","volume":"112","author":"Pommier","year":"1992","journal-title":"Surgery"},{"key":"2023050106125694600_ref4","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1200\/JCO.2002.20.4.941","article-title":"Adrenocortical carcinoma: clinical, morphologic, and molecular characterization","volume":"20","author":"Stojadinovic","year":"2002","journal-title":"J Clin Oncol"},{"key":"2023050106125694600_ref5","doi-asserted-by":"crossref","first-page":"2189","DOI":"10.1056\/NEJMoa1200966","article-title":"Combination chemotherapy in advanced adrenocortical carcinoma","volume":"366","author":"Fassnacht","year":"2012","journal-title":"N Engl J Med"},{"key":"2023050106125694600_ref6","doi-asserted-by":"crossref","first-page":"2816","DOI":"10.1002\/cncr.24331","article-title":"Radiotherapy in adrenocortical carcinoma","volume":"115","author":"Polat","year":"2009","journal-title":"Cancer"},{"key":"2023050106125694600_ref7","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1001\/archsurg.1991.01410280059008","article-title":"Recurrent or metastatic disease in select patients with adrenocortical carcinoma. 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