{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T17:59:07Z","timestamp":1791136747557,"version":"4.1.0"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"3","content-domain":{"domain":["eje.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2013,9]]},"abstract":"<jats:sec><jats:title>Context<\/jats:title><jats:p>Mitotane plasma concentrations \u226514\u200amg\/l have been shown to predict tumor response and better survival in patients with advanced adrenocortical carcinoma (ACC). A correlation between mitotane concentrations and patient outcome has not been demonstrated in an adjuvant setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare recurrence-free survival (RFS) in patients who reached and maintained mitotane concentrations \u226514\u200amg\/l vs patients who did not.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and setting<\/jats:title><jats:p>Retrospective analysis at six referral European centers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>Patients with ACC who were radically resected between 1995 and 2009 and were treated adjuvantly with mitotane targeting concentrations of 14\u201320\u200amg\/l.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>RFS (primary) and overall survival (secondary).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 122 patients included, 63 patients (52%) reached and maintained during a median follow-up of 36 months the target mitotane concentrations (group 1) and 59 patients (48%) did not (group 2). ACC recurrence was observed in 22 patients of group 1 (35%) and 36 patients in group 2 (61%). In multivariable analysis, the maintenance of target mitotane concentrations was associated with a significantly prolonged RFS (hazard ratio (HR) of recurrence: 0.418, 0.22\u20130.79; <jats:italic>P<\/jats:italic>=0.007), while the risk of death was not significantly altered (HR: 0.59, 0.26\u20131.34; <jats:italic>P<\/jats:italic>=0.20). Grades 3\u20134 toxicity was observed in 11 patients (9%) and was managed with temporary mitotane discontinuation. None of the patients discontinued mitotane definitively for toxicity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Mitotane concentrations \u226514\u200amg\/l predict response to adjuvant treatment being associated with a prolonged RFS. A monitored adjuvant mitotane treatment may benefit patients after radical removal of ACC.<\/jats:p><\/jats:sec>","DOI":"10.1530\/eje-13-0242","type":"journal-article","created":{"date-parts":[[2013,5,24]],"date-time":"2013-05-24T01:13:51Z","timestamp":1369358031000},"page":"263-270","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-1","source":"Crossref","is-referenced-by-count":119,"title":["Mitotane levels predict the outcome of patients with adrenocortical carcinoma treated adjuvantly following radical resection"],"prefix":"10.1093","volume":"169","author":[{"given":"M","family":"Terzolo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A E","family":"Baudin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Ardito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Kroiss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Leboulleux","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F","family":"Daffara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Perotti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R A","family":"Feelders","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J H","family":"deVries","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B","family":"Zaggia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"De Francia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Volante","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H R","family":"Haak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B","family":"Allolio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Al Ghuzlan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Fassnacht","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Berruti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","reference":[{"issue":"1","key":"1_21261606","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1097\/01.cco.0000198976.43992.14","volume":"18","author":"Roman","year":"2006","journal-title":"Current opinion in oncology","ISSN":"https:\/\/id.crossref.org\/issn\/1040-8746","issn-type":"print"},{"issue":"8","key":"2_5707974","doi-asserted-by":"publisher","first-page":"914","DOI":"10.1001\/archsurg.1997.01430320116020","volume":"132","author":"Terzolo","year":"1997","journal-title":"Archives of Surgery","ISSN":"https:\/\/id.crossref.org\/issn\/0004-0010","issn-type":"print"},{"issue":"3","key":"3_19492745","doi-asserted-by":"publisher","first-page":"667","DOI":"10.1677\/erc.1.01029","volume":"12","author":"Schteingart","year":"2005","journal-title":"Endocrine-Related Cancer","ISSN":"https:\/\/id.crossref.org\/issn\/1351-0088","issn-type":"print"},{"issue":"6","key":"4_21809127","doi-asserted-by":"publisher","first-page":"2027","DOI":"10.1210\/jc.2005-2639","volume":"91","year":"2006","journal-title":"Journal of Clinical Endocrinology &amp; 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