Abstract：
:Adrenocortical cancer (ACC) is a rare, challenging disease with a broad range of clinical presentations. Often presenting in an advanced stage with a large, locally invasive primary tumor or with Cushing's syndrome, it requires a multidisciplinary approach to treatment. We discuss controversies in the evaluation and management of ACC. We conclude that the role of (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) remains unclear and that it should be employed sparingly. Biopsies should be performed only when metastatic disease is present and a primary tumor has not been clearly established. Care should be taken in using the Weiss criteria to make decisions regarding prognosis. Surgery is the preferred intervention initially and at the time of recurrence, and every effort should be made to attempt a surgical resection. The latter should be an open resection; laparoscopic resection should not be performed if there is a high suspicion of ACC. The use of mitotane in patients without evidence of disease remains controversial. Systemic chemotherapy is effective in patients with widely metastatic disease or as an adjunct to a surgical intervention and should focus on regimens that have been shown to effect responses; "novel targeted therapies" should not be employed as first-line treatment. Radiofrequency ablation (RFA) and cryoablation can be very helpful but are still under evaluation; embolization with or without chemotherapy may be used as a surgical adjunct. The role of radiation remains to be defined. Finally, physicians caring for these patients need to recognize that Cushing's disease is a debilitating problem that should be managed aggressively; expecting chemotherapy to solve this complication is not appropriate.
journal_name
Semin Oncoljournal_title
Seminars in oncologyauthors
Balasubramaniam S,Fojo Tdoi
10.1053/j.seminoncol.2010.10.011subject
Has Abstractpub_date
2010-12-01 00:00:00pages
619-26issue
6eissn
0093-7754issn
1532-8708pii
S0093-7754(10)00181-8journal_volume
37pub_type
杂志文章,评审abstract：:90Y ibritumomab tiuxetan (Zevalin; Biogen Idec Inc, Cambridge, MA), the first radioimmunotherapeutic agent approved by the US Food and Drug Administration, is a promising treatment option in patients with relapsed or refractory low-grade, follicular, or transformed B-cell non-Hodgkin's lymphoma, including patients wit...
journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：10.1053/j.seminoncol.2003.10.003
更新日期：2003-12-01 00:00:00
abstract：:Approximately 25% of all lung cancer cases diagnosed in 1993 were due to small cell lung cancer (SCLC). Approximately one third of all SCLC patients present with limited disease. Efforts to improve treatment results for patients with limited-stage SCLC include two recent meta-analyses of combined-modality treatment in...
journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：
更新日期：1998-02-01 00:00:00
abstract：:Targeted therapy for breast cancer has existed since 1986, when Beatson published his observations on oophorectomy. In the past 5 years monoclonal antibodies and tyrosine kinase inhibitors have been evaluated in phase I and II clinical trials of breast cancer. Trastuzumab (Herceptin; Genentech, Inc, South San Francisc...
journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：10.1053/j.seminoncol.2004.02.018
更新日期：2004-04-01 00:00:00
abstract：:Single-agent docetaxel has been shown to produce a significant decrease in prostate-specific antigen (PSA) levels among patients with hormone-refractory prostate cancer (HRPC). A recent study also showed that exisulind, a sulfone metabolite of the nonsteroidal anti-inflammatory drug sulindac, lengthens the median PSA ...
journal_title：Seminars in oncology
pub_type： 临床试验,杂志文章
doi：10.1016/s0093-7754(01)90156-3
更新日期：2001-08-01 00:00:00
abstract：:The current study was conducted to determine the risk of adverse outcomes among patients with monoclonal gammopathy of undetermined significance (MGUS) of the IgM class. Two hundred thirteen patients with IgM MGUS were identified in southeastern Minnesota from 1960 to 1994. The primary end point was progression to lym...
journal_title：Seminars in oncology
pub_type： 杂志文章
doi：10.1053/sonc.2003.50062
更新日期：2003-04-01 00:00:00
abstract：:The current resurgence in the use of nomograms as diagnostic and prognostic tools has legitimate roots in their effectiveness in facilitating communication between the doctor and patient. By returning to a more classical approach to nomography, graphical insights can further enlighten the patient beyond what can be ac...
journal_title：Seminars in oncology
pub_type： 杂志文章
doi：10.1053/j.seminoncol.2009.12.003
更新日期：2010-02-01 00:00:00
abstract：:The humanized anti-p185(HER2) monoclonal antibody trastuzumab has been shown to effectively inhibit the growth of HER2-overexpressing breast cancer cells in vivo and in vitro. The treatment of cancer cells with trastuzumab results in downregulation of the HER2 receptor. Further downstream cellular events include the a...
journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：10.1016/s0093-7754(01)90276-3
更新日期：2001-10-01 00:00:00
abstract：:Spirituality can exert a tremendous impact on ones health and promote recovery from trauma and illness, including cancer. Throughout the history of mankind, spirituality and religion have played a major role in healing a variety of physical and mental illnesses. Cancer is one of the most devastating illnesses, as it a...
journal_title：Seminars in oncology
pub_type： 杂志文章
doi：10.1053/j.seminoncol.2004.11.017
更新日期：2005-04-01 00:00:00
abstract：:Most important is the physician's attitude, energy, and skill focused toward helping the patient through the difficulties in the last weeks of life. Many causes of nausea, dyspnea, and other troublesome symptoms can be effectively treated, and pharmacologic palliation is nearly always possible. A multidisciplinary tea...
journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：
更新日期：1994-12-01 00:00:00
abstract：:Small cell carcinoma (SCC) has become recognized as a distinct, though relatively infrequent, clinical pathology that occurs in multiple sites throughout the head and neck. Excluding cases that are considered to arise from skin, SCC in the head and neck has been found to develop in nearly all structures associated wit...
journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：10.1053/j.seminoncol.2006.10.024
更新日期：2007-02-01 00:00:00
abstract：:Inhibition of cellular DNA synthesis is the major action of gemcitabine. In cells, this drug is converted to its triphosphate (dFdCTP), which is incorporated into DNA and terminates DNA strand elongation. After incorporation of gemcitabine nucleotide into the DNA strand, one more deoxynucleotide is incorporated, and t...
journal_title：Seminars in oncology
pub_type： 杂志文章
doi：
更新日期：1995-08-01 00:00:00
abstract：:Elderly patients with malignant gliomas present unique treatment challenges. Data are limited on the efficacy of various treatment modalities for high-grade gliomas in the elderly patient population, particularly for patients over 70 years of age, and the most appropriate treatment strategies remain a matter of debate...
journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：10.1053/j.seminoncol.2003.11.027
更新日期：2003-12-01 00:00:00
abstract：:Solid organ tumors associated with neoangiogenesis, as measured by increased microvessel density (MVD), have poorer prognoses. A similar observation of increased MVD has been made in hematologic malignancies; however, its prognostic significance remains unknown. We investigated changes in MVD in 122 newly diagnosed mu...
journal_title：Seminars in oncology
pub_type： 杂志文章
doi：10.1016/s0093-7754(01)90025-9
更新日期：2001-12-01 00:00:00
abstract：:We studied the efficacy of endoscopic variceal ligation (EVL) in 16 patients with tumor thrombus of the portal vein trunk (Vp3) associated with hepatocellular carcinoma. The average (+/-SD) number of O rings used was 9.0 +/- 5.0 for the esophageal varices (n = 7) and 16.4 +/- 4.5 for the esophagogastric varices (n = 9...
journal_title：Seminars in oncology
pub_type： 杂志文章
doi：
更新日期：1997-04-01 00:00:00
abstract：:Monoclonal antibodies (mAbs) and their directly derived cell-based application known as chimeric antigen receptors (CARs) ensue from the need to develop novel therapeutic strategies that retain high anti-tumor activity, but carry reduced toxicity compared to conventional chemo- and radiotherapies. In this concise revi...
journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：10.1053/j.seminoncol.2014.08.005
更新日期：2014-10-01 00:00:00
abstract：:Clinical research in the treatment of epithelial ovarian cancer has entered a new phase. A pivotal Gynecologic Oncology Group study demonstrated that paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) plus cisplatin was superior to the previous standard therapy of cyclophosphamide plus cisplatin. Confirma...
journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：
更新日期：1997-10-01 00:00:00
abstract：:Follicular lymphoma is a low-grade, indolent non-Hodgkin's lymphoma characterized by the presence of the t(14;18) translocation. The detection of this translocation using polymerase chain reaction techniques has been increasingly studied. However, the diagnostic and prognostic value of detecting t(14;18) rearrangement...
journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：
更新日期：2000-12-01 00:00:00
abstract：:We resected 158 cases of hepatocellular carcinoma (HCC), including 20 (12.6%) cases of large HCC. These 20 cases were divided into group 1 (curative resection, n = 9) and group 2 (noncurative resection, n = 11). The clinicopathologic features and long-term survival of the cases were evaluated. In groups 1 and 2, porta...
journal_title：Seminars in oncology
pub_type： 杂志文章
doi：
更新日期：1997-04-01 00:00:00
abstract：:In 2002, the American Joint Committee on Cancer (AJCC) revised the staging system for cutaneous melanoma on the basis of a survival analysis of important melanoma prognostic factors. Features of the revised system include new strata for primary tumor thickness, incorporation of primary tumor ulceration as an important...
journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：10.1053/j.seminoncol.2004.03.018
更新日期：2004-06-01 00:00:00
abstract：:The purpose of this study was to evaluate the combination of gemcitabine, paclitaxel, and carboplatin in patients with advanced non-small cell lung cancer. Previously untreated patients with stage IIIB or IV non-small cell lung cancer were enrolled into this trial. Sixty-nine patients from the phase II portion and eig...
journal_title：Seminars in oncology
pub_type： 临床试验,杂志文章,多中心研究
doi：
更新日期：2000-02-01 00:00:00
abstract：:The outcome of chemotherapy for patients with stage IV melanoma is unsatisfactory, since durable responses are rarely achieved. More experimental treatments, such as vaccine approaches, antibody treatments, and gene therapy are being developed and are of high scientific interest; however, their efficacy in advanced me...
journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：10.1053/sonc.2002.35240
更新日期：2002-10-01 00:00:00
abstract：:Preliminary clinical studies demonstrated that 5' nor-anhydro-vinblastine, Navelbine (NVB) has a broader antitumor activity and fewer neurotoxic effects than vinblastine or vincristine. The tectal plate anlage of mouse embryos at the earliest stages of neuronal differentiation were used to analyze and compare the effe...
journal_title：Seminars in oncology
pub_type： 杂志文章
doi：
更新日期：1989-04-01 00:00:00
abstract：:A new era involving the evaluation of recombinant vaccines for colon cancer has begun with the concurrent emergence of insights and technologies in the fields of molecular biology and immunology. These advances include (I) the identification and cloning of an array of genes associated with the neoplastic process, such...
journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：
更新日期：1999-12-01 00:00:00
abstract：:This phase I trial was designed to determine the maximum tolerated dose of paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) given as a 3-hour infusion in combination with carboplatin (400 mg/m2) as first-line chemotherapy for stage IIIC/IV ovarian adenocarcinoma. After premedication, paclitaxel was infu...
journal_title：Seminars in oncology
pub_type： 临床试验,杂志文章
doi：
更新日期：1996-10-01 00:00:00
abstract：:HER2 is a transmembrane growth factor receptor found in normal and malignant breast epithelial cells. Phosphorylation of the intracellular tyrosine kinase results in intracellular signaling and activation of genes involved in cell growth. Overexpression of HER2 has independent prognostic significance in early breast c...
journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：
更新日期：2001-12-01 00:00:00
abstract：:In non-small cell lung cancer (NSCLC), the first immune checkpoint inhibitor to be approved by the US Food and Drug Administration was nivolumab, based on a survival advantage over docetaxel in recurrent squamous NSCLC, a difficult-to-treat histology. In addition, several other immune checkpoint inhibitors are also in...
journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：10.1053/j.seminoncol.2015.09.019
更新日期：2015-10-01 00:00:00
abstract：:A large meta-analysis showed that chemotherapy results in significant prolongation of survival for patients with non-small cell lung cancer (NSCLC). Pemetrexed is a new multitargeted antifolate chemotherapeutic agent that has shown activity in NSCLC and appears to be similar to the third-generation antitumor agents cu...
journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：10.1053/sonc.2002.37470
更新日期：2002-12-01 00:00:00
abstract：:The role of radiation therapy in the management of breast cancer continues to evolve. For patients with early stage breast cancer, hypofractionated whole breast irradiation following breast conserving surgery now represents the standard of care based on randomized data with long-term efficacy and toxicity outcomes. Pa...
journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：10.1053/j.seminoncol.2020.05.003
更新日期：2020-08-01 00:00:00
abstract：:Lymphomas of the head and neck arise in Waldeyer's ring, the salivary glands, nasal cavity, paranasal sinuses, thyroid gland, and orbit. Though anatomically in close proximity, lymphomas arising in these sites have distinct clinical characteristics. Factors that appear to influence the pattern of disease include concu...
journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：
更新日期：1999-06-01 00:00:00
abstract：:The ability to predict the biological behavior of breast tumors can allow selection of the optimum treatment and follow-up strategies. Conventionally, tumor size, lymph node metastases, and histopathologic features have been used to determine the risk of systemic relapse. The discovery of a number of specific genetic ...
journal_title：Seminars in oncology
pub_type： 杂志文章,评审
doi：
更新日期：1996-08-01 00:00:00
