Benefits of Adjuvant Mitotane after Resection of Adrenocortical Carcinoma: A Systematic Review and Meta-Analysis

Background. The adjuvant use of mitotane on adrenocortical carcinoma (ACC) has always been in controversy. We aimed to assess the prognostic benefits of adjuvant mitotane after resection of ACC in patients without distant metastasis. Methods. The PubMed, WoS, Embase, and Cochrane Library databases w...

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Bibliographic Details
Published in:BioMed research international 2018-01, Vol.2018 (2018), p.1-8
Main Authors: Lu, Yiping, Liang, Jiayu, Zou, Zijun, Liu, Zhihong, Tang, Yongquan, Zhu, Yuchun
Format: Article
Language:English
Subjects:
Adjuvant treatment
Adolescent
Adrenal Cortex Neoplasms - drug therapy
Adrenal Cortex Neoplasms - surgery
Adrenocortical Carcinoma - drug therapy
Adrenocortical Carcinoma - surgery
Adult
Aged
Analysis
Antineoplastic Agents, Hormonal - therapeutic use
Apoptosis
Bias
Cancer
Carcinoma
Chemotherapy
Chemotherapy, Adjuvant
Clinical trials
Confidence intervals
Endocrinology
Endoplasmic reticulum
Female
Health aspects
Humans
Male
Medical prognosis
Medical research
Medicine, Experimental
Meta-analysis
Metabolism
Metabolites
Metastases
Metastasis
Middle Aged
Mitotane
Mitotane - therapeutic use
Mortality
Neoplasm Recurrence, Local
Neuroendocrine tumors
Oncology
Patients
Prospective Studies
Radiation therapy
Researchers
Retrospective Studies
Review
Studies
Surgery
Survival
Systematic review
Young Adult
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Summary:Background. The adjuvant use of mitotane on adrenocortical carcinoma (ACC) has always been in controversy. We aimed to assess the prognostic benefits of adjuvant mitotane after resection of ACC in patients without distant metastasis. Methods. The PubMed, WoS, Embase, and Cochrane Library databases were systematically searched. Recurrence-free survival (RFS) and overall survival (OS) were adopted as measurements. A meta-analysis was conducted based on hazard ratio (HR) with 95% confidence interval (CI). A study was included only if the enrolled patients underwent resection of ACC without adjuvant chemotherapy except mitotane. Results. A total of 5 retrospective studies reporting on 1249 patients were included for this meta-analysis. The meta-analysis showed that adjuvant mitotane was significantly associated with prolonged RFS (HR = 0.62; 95%CI, 0.42-0.94; P < 0.05) and prolonged OS (HR = 0.69; 95%CI, 0.55-0.88, P < 0.05). Conclusion. After comprehensive review, current evidence suggests that adjuvant mitotane significantly decreases the recurrence rate and mortality after resection of ACC in patients without distant metastasis, but these findings need further demonstration from prospective controlled trials.
ISSN:2314-6133
2314-6141
DOI:10.1155/2018/9362108