ES08DIAGNOSTIC AND THERAPEUTIC STRATEGIES OF ADRENOCORTICAL CARCINOMA-A 3-INSTITUTION EXPERIENCE

This paper reviews the diagnostic, therapeutic strategies and outcomes of ADCC in 3 Institutions between Newcastle and Sheffield in United Kingdom and Putrajaya, Malaysia. A 10-year retrospective analysis of proven cases of ADCC was collected from January 1997 to December 2006. The patients' demographic data, clinical manifestation, site and size of the tumour were analysed. The record of metastasis, and therapeutic modality and outcomes were evaluated. A total of 22 cases of ADCC were documented in United Kingdom with 11 cases in each respective center. 16 cases were reviewed from Putrajaya. There was no gender preponderance and age significance. Cushing's Syndrome was the most common clinical manifestation (36.4%) in United Kingdom and (37.5%) in Putrajaya. The mean size of the ADCC was 9.3 cm (5-15 cm) in Newcastle and 9.8 cm (6-15 cm) in Sheffield as compared to 15.7 cm (5-25 cm) in Putrajaya. There were 12(75%) of patients in Putrajaya were diagnosed with Stage IV disease upon presentation whilst only 3(27.3%) and 5(45.4%) patients had metastasis noted in Newcastle and Sheffield respectively. Of note, 7(63.3%) patients in Sheffield were offered radical adrenalectomy. Our data revealed that the 2 years survival of patients who had radical approach in Sheffield has the highest rate of survival of 8(72.7%) as compared to 5(45.4%) in Newcastle and 2(12.5%) in Putrajaya. Surgical removal remains the only form of curative therapy and hope of prolonged survival. The poorer prognosis of patients in Putrajaya may be attributed to the advanced stage of the disease. [PUBLICATION ABSTRACT]