CC BY-NC-ND 4.0 · Horm Metab Res 2024; 56(01): 91-98
DOI: 10.1055/a-2209-6022

Current Evidence on Local Therapies in Advanced Adrenocortical Carcinoma

Otilia Kimpel
1   Division of Endocrinology and Diabetes, Department of Medicine, University Hospital, University of Würzburg, Würzburg, Germany
Ulrich Dischinger
1   Division of Endocrinology and Diabetes, Department of Medicine, University Hospital, University of Würzburg, Würzburg, Germany
Barbara Altieri
1   Division of Endocrinology and Diabetes, Department of Medicine, University Hospital, University of Würzburg, Würzburg, Germany
Carmina Teresa Fuss
1   Division of Endocrinology and Diabetes, Department of Medicine, University Hospital, University of Würzburg, Würzburg, Germany
Bülent Polat
2   Department of Radiation Oncology, University Hospital, University of Würzburg, Würzburg, Germany
Ralph Kickuth
3   Institute of Diagnostic and Interventional Radiology, University Hospital, University of Würzburg, Würzburg, Germany
Matthias Kroiss
1   Division of Endocrinology and Diabetes, Department of Medicine, University Hospital, University of Würzburg, Würzburg, Germany
4   Department of Internal Medicine IV, University Hospital, Ludwig-Maximilians-Universität München, München, Germany
Martin Fassnacht
1   Division of Endocrinology and Diabetes, Department of Medicine, University Hospital, University of Würzburg, Würzburg, Germany
5   Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany
› Author Affiliations
Funding Information Clinician Scientist programme RISE funded by the Else Kröner-Fresenius-Stiftung & the Eva Luise und Horst Köhler Stiftung — German Research Foundation (DFG) project 314061271 (TRR-CRC 205) — project 314061271 (TRR-CRC 205)


International guidelines emphasise the role of local therapies (LT) for the treatment of advanced adrenocortical carcinoma (ACC). However, large studies are lacking in this field. Therefore, we performed a review of the literature to synthesise current evidence and develop clinical guidance. PubMed database was searched for systematic literature. We identified 119 potentially relevant articles, of which 21 could be included in our final analysis. All were retrospective and reported on 374 patients treated with LT for advanced ACC (12 studies on radiotherapy, 3 on transarterial chemoembolisation and radioembolisation, 4 on image-guided thermal ablation [radiofrequency, microwave ablation, and cryoablation, and two studies reporting treatment with several different LT]). Radiotherapy was frequently performed with palliative intention. However, in most patients, disease control and with higher dosage also partial responses could be achieved. Data for other LT were more limited, but also point towards local disease control in a significant percentage of patients. Very few studies tried to identify factors that are predictive on response. Patients with a disease-free interval after primary surgery of more than 9 months and lesions<5 cm might benefit most. Underreporting of toxicities may be prevalent, but LT appear to be relatively safe overall. Available evidence on LT for ACC is limited. LT appears to be safe and effective in cases with limited disease and should be considered depending on local expertise in a multidisciplinary team discussion.

Publication History

Received: 19 June 2023

Accepted after revision: 25 September 2023

Article published online:
03 January 2024

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