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cc by (c) Araujo Castro, Marta et al, 2025
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/222397

Spanish consensus on the diagnosis and management of adrenocortical carcinoma

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Adrenocortical carcinoma (ACC) is a rare endocrine malignancy with an estimated incidence of 0.7-2 cases per million/year. The rarity of this disease, coupled with limited preclinical models and clinical trials, has hindered progress, resulting in poor outcomes, with a 5-year survival rate of approximately 35%. Currently, the only available curative treatment is complete surgical resection of the adrenal tumor. For unresectable or metastatic ACC, the current standard therapeutic modalities are mitotane, chemotherapy, radiotherapy and locoregional treatments; however, these are noncurative. Mitotane has an adrenolytic and anti-steroidogenic effect, and it is used in the adjuvant setting for high-risk patients, as systemic therapy for metastatic disease, and/or to control hormonal secretion. While key pathways in ACC pathogenesis have been identified as potential therapeutic targets, results with targeted therapies remain modest, showing that there is a clinical unmet need for novel treatments or new combinations of exiting drugs. Effective management requires a multidisciplinary team of experts to optimize outcomes for patients. This article presents a multidisciplinary consensus on the diagnosis, management, prognosis and follow-up of patients with ACC, and the approach to two special contexts, ACC in pregnant women and hormone-producing ACC. The consensus was coordinated by the Spanish Society of Endocrinology and Nutrition (SEEN) and the Spanish Group of Neuroendocrine and Endocrine Tumors (GETNE), with contribution from experts from related societies including the Spanish Association of Surgeons (AEC), Spanish Society of Urology (AEU), Anatomic-Pathology (SEAP), Nuclear Medicine (SEMNIM), Medical Oncology (SEOM) and Radiotherapeutic Oncology (SEOR).

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ARAUJO CASTRO, Marta, ÁLVAREZ ESCOLÁ, Cristina, CASTERÀS, Anna, CARMONA BAYONAS, Alberto, CHIARA, María dolores, HANZU, Felicia a., HERNANDO CUBERO, Jorge, VERCHER CONEJERO, José luís, RODRÍGUEZ FRAILE, Macarena, GÓMEZ DOS SANTOS, Victoria, JIMÉNEZ FONSECA, Paula, GIRALDO, Alexandra, VALDÉS, Nuria, VIDAL, Oscar, OLMO GARCÍA, Maribel del, CAPDEVILA, Jaume. Spanish consensus on the diagnosis and management of adrenocortical carcinoma. _Endocrine Related Cancer_. 2025. Vol. 32, núm. 5. [consulta: 26 de febrer de 2026]. [Disponible a: https://hdl.handle.net/2445/222397]

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