Treatment and Prognosis
The primary treatment for adrenocortical carcinoma is to surgically remove the tumor. Chemotherapy may not be completely effective and is often given to shrink the tumor prior to surgery. The drugs administered has in some treatment protocols include: –
Mitotane is most frequently used and can prolong recurrence-free survival in patients who have been subjected to radical surgery to remove the adrenocortical carcinoma.
Radiotherapy, radiofrequency ablation and hormonal therapy form part of the palliative care.
The prognosis for adrenocortical carcinoma is generally poor, unlike the case of benign tumors of the cortex. The deciding factors are age of the patient and the stage of the tumor when diagnosed.
Five-year disease-free survival for stages I-III is approximately 30%. Metastasis indicates very poor prognosis.
Future advances in the management of this cancer will mainly depend on a better understanding of the molecular pathogenesis that can help in the use of modern cancer treatments (e.g. tyrosine kinase inhibitors).