Karolina M. Nowak

Prognostic factors in adrenocortical carcinoma: data from a large Polish series

Introduction Adrenocortical carcinoma (ACC) is a rare malignancy, associated with poor outcome and few therapeutic options. Despite increasing attention, the knowledge about the clinical course and treatment of these tumors is limited. Objectives Survival rates in ACC are still low and the percentage of relapse is high. Thus, it is crucial to identify the prognostic factors of overall survival (OS) and recurrence‑free survival (RFS). Patients and methods This was a retrospective analysis of 66 patients diagnosed with ACC between 2002 and 2015. Results The median OS was 43.5 months, 78.19 months for stage I + II, 22.95 months for stage III, and 19.54 months for stage IV ACC. Older age, stage IV ACC, margin status R2, and no mitotane treatment were associated with poor OS. Low Ki67 and mitotic indices were related to improved OS in a univariate analysis. The median RFS was 101.1 months. Disease recurrence after potentially curative surgery was reported in 1 patient (25%) with stage I, 12 patients (46%) with stage II, and 9 patients (45%) with stage III ACC. Male sex and no mitotane treatment were associated with a reduced RFS in a multivariate analysis and higher Ki67 and mitotic indices in the univariate analysis. Conclusions Ki67 and mitotic indices should be considered as prognostic factors when planning the adjuvant treatment of ACC. Mitotane treatment may be independently associated with better outcomes regardless of the tumor stage.

Prevention and treatment of steroid-induced osteoporosis – recommendations vs clinical practice

1Department of Endocrinology, Centre of Postgraduate Medical Education, Bielański Hospital, Warsaw Head of Department: Professor Wojciech Zgliczyński, MD, PhD 2Department of Rheumatology, Eleonora Reicher National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw Head of Department: Professor Piotr Głuszko, MD, PhD 3Department of General and Experimental Pathology, 2nd Faculty of Medicine, Medical University of Warsaw Head of Department: Dariusz Szukiewicz, MD, PhD 4Department of Systemic Connective Tissue Diseases, Eleonora Reicher National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw Head of Department: Professor Marzena Olesińska, MD, PhD

Adrenal tumour bigger than 5 cm — what could it be? An analysis of 139 cases

INTRODUCTION There is an increasing number of adrenal being tumours discovered incidentally during imaging examinations performed for many different indications. Radiological findings suggesting adrenal pathology may be caused by true adrenal tumours or by other retroperitoneal masses. Generally, the larger the tumour, the higher the possibility of adrenal cancer. MATERIAL AND METHODS Analysis of our data - 139 operations performed over 11 years (2004-2014) in patients with tumours in the adrenal area larger than 5 cm. RESULTS The most common finding was adrenal cancer (25.2%), benign adenoma (24.5%), pheochromocytoma (12.9%), and metastatic cancer (10.1%). In total, there were 19 various histopathological diagnoses in this group. CONCLUSION Although adrenal cancer is the most likely diagnosis in large adrenal tumours, a broad spectrum of various adrenal and retroperitoneal tumours with size more than 5 cm can be found in such patients.