SynthesisThe Journal of clinical endocrinology and metabolism2025
Efficacy and Safety of Radiotherapy and Systemic Treatments in Adrenocortical Carcinoma: Systematic Review and Meta-Analysis.
Synthesis in The Journal of clinical endocrinology and metabolism, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Efficacy and Safety of Radiotherapy and Systemic Treatments in Adrenocortical Carcinoma: Systematic Review and Meta-Analysis.The Journal of clinical endocrinology and metabolism · 2025Pooled it
- Diagnostic accuracy of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in the differential diagnosis of adrenocortical carcinoma: a retrospective study.Translational andrology and urology · 2025Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
contextAdrenocortical carcinoma (ACC) is a rare, aggressive malignancy with a high recurrence and mortality rate even after complete resection. Therefore, intensification of adjuvant therapies is crucial, although their effectiveness remains controversial.
objectiveThis study aimed to determine the efficacy and safety of available treatments by considering the prognostic factors affecting disease outcomes.
methodsThe search was conducted across 3 databases (PubMed, Embase, and CENTRAL) in October 2024. Eligible studies compared overall survival (OS) and recurrence-free survival (RFS) in patients with ACC treated with and without systemic (mitotane, cytotoxic chemotherapy) or localized (radiotherapy) nonsurgical treatments. In total, 86 studies met the inclusion criteria for the systematic review, and 62 for the meta-analysis. Two reviewers extracted data independently. Adjusted hazard ratios (aHR) with 95% CI were calculated for survival outcomes.
resultsMitotane significantly improves OS (aHR: 0.54; CI: 0.41-0.70) and RFS (aHR: 0.60; CI: 0.43-0.84), even in stage I-III disease (OS aHR: 0.71; CI: 0.52-0.98; RFS aHR: 0.65; CI: 0.50-0.85). Radiotherapy showed a trend toward improved OS (aHR: 0.66; CI: 0.38-1.15) and RFS (aHR: 0.65; CI: 0.35-1.23), with significant benefits in stage I-III (OS aHR: 0.68; CI: 0.50-0.93; RFS aHR: 0.71; CI: 0.63-0.81). The impact of cytotoxic chemotherapy on OS remains uncertain (aHR: 0.61; CI: 0.08-4.78).
conclusionMitotane significantly improves survival outcomes in patients with ACC, while radiotherapy exhibits potential benefits, particularly in localized disease. Further research is needed to verify the efficacy of cytotoxic chemotherapy, and randomized controlled trials are required to provide robust evidence of different treatment approaches.
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