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Personalized Medicine in Benign and Malignant Adrenal Tumors
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Personalized Medicine in Benign and Malignant Adrenal Tumors

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Mechanisms of Diseases".

Deadline for manuscript submissions: closed (15 January 2023) | Viewed by 4439

Special Issue Editors

Prof. Dr. Massimo Terzolo

E-Mail Website
Guest Editor
Internal Medicine, Department of Clinical and Biological Sciences, San Luigi Gonzaga Hospital, University of Turin, 10043 Orbassano, TO, Italy
Interests: adrenocortical cancer; cushing; adrenal incidentaloma; adrenal insufficiency; mitotane
Dr. Soraya Puglisi

E-Mail Website
Guest Editor
Internal Medicine, Department of Clinical and Biological Sciences, San Luigi Gonzaga Hospital, University of Turin, 10043 Orbassano, Turin, Italy
Interests: adrenocortical cancer; cushing; adrenal incidentaloma; adrenal insufficiency; mitotane

Special Issue Information

Dear Colleagues,

The widespread application of high-resolution cross-sectional scanning in modern medicine has led to the frequent discovery of clinically silent adrenal tumors, called “adrenal incidentalomas”. They are becoming increasingly common and have attracted attention to all adrenal tumors that are no longer considered rare. The efforts of clinicians are focused on the differential diagnosis between benign and malignant adrenal masses and identification of excess in hormone secretions (mainly hypercortisolism and primary aldosteronism), which may potentially worsen comorbidities (cardiovascular, metabolic or bone complications) and increased mortality. In this context, the impact of adrenalectomy is still debated, while new medical approaches are emerging in recent years.

Although the majority of adrenal masses are benign, adrenocortical cancer (ACC) can occur, burdened by grim prognosis, strong propensity to recur after surgery, and a limited range of available therapeutic options. Therefore, great efforts are required to identify reliable prognostic factors, novel methods to secure early diagnosis, and new markers for a timely detection of tumor recurrence following adrenalectomy. Given that the available medical therapies have limited efficacy and are quite toxic, the identification of new molecular targets that can be druggable and the development of innovative therapeutic agents is a definitive priority to improve patient care. Meanwhile, studies focusing on the efficacy and safety of existing therapies, as well as on quality of life, should be promoted.

This Special Issue will focus on all of these aspects, in particular on genetic, new “omics” markers, differential diagnosis, prognostic factors, as well as therapeutic approaches and their effects. Both original research and review articles are welcome.

Prof. Dr. Massimo Terzolo
Dr. Soraya Puglisi
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Personalized Medicine is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • adrenal tumors
  • adrenal incidentaloma
  • adrenocortical cancer
  • differential diagnosis of adrenal masses
  • subclinical hypercortisolism
  • primary aldosteronism
  • genetics
  • adrenalectomy
  • mitotane
  • quality of life

Published Papers (2 papers)

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Research

7 pages, 532 KiB  
Article
The Effect of Surgeon Expertise on the Outcome of Patients with Adrenocortical Carcinoma
by Anja Barac Nekic, Nikola Knezevic, Karin Zibar Tomsic, Ivana Kraljevic, Annemarie Balasko, Tanja Skoric Polovina, Mirsala Solak, Tina Dusek, Darko Kastelan and Croatian ACC Study Group
J. Pers. Med. 2022, 12(1), 100; https://doi.org/10.3390/jpm12010100 - 13 Jan 2022
Cited by 1 | Viewed by 1941
Abstract
Complete surgical removal of adrenocortical carcinoma (ACC) represents the only chance of long-term cure. In this study, we compared the long-term outcomes of ACC patients depending on whether they had adrenal surgery performed in a high-volume (HVC) or in a low-volume (LVC) center. [...] Read more.
Complete surgical removal of adrenocortical carcinoma (ACC) represents the only chance of long-term cure. In this study, we compared the long-term outcomes of ACC patients depending on whether they had adrenal surgery performed in a high-volume (HVC) or in a low-volume (LVC) center. This retrospective study included 49 patients from the Croatian ACC Registry with the European Network for the Study of Adrenal Tumors (ENSAT) stage I–III ACC, of which 35 underwent surgery in a HVC whereas 14 of them were operated in one of the LVCs. Patients operated in the LVCs had a significantly higher rate of ACC recurrence (57.1% vs. 22.9%; p = 0.02). Accordingly, RFS was significantly longer in patients operated on in HVC (p = 0.04). The difference in RFS remained significant after controlling for age, gender, tumor size, Ki-67 index, Weiss score, and type of surgery (HR 4.55; 95% CI 1.16–17.88; p = 0.03). In addition, there is a tendency towards longer DSS in patients in the HVC group compared to those in the LVC group (p = 0.05). These results point to the centralization of adrenal surgery as a key prerequisite for improving the outcomes of ACC patients. Full article
(This article belongs to the Special Issue Personalized Medicine in Benign and Malignant Adrenal Tumors)
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17 pages, 3911 KiB  
Article
Stimulated Expression of CXCL12 in Adrenocortical Carcinoma by the PPARgamma Ligand Rosiglitazone Impairs Cancer Progression
by Giulia Cantini, Laura Fei, Letizia Canu, Elena Lazzeri, Mariangela Sottili, Michela Francalanci, Maria Lucia Angelotti, Giuseppina De Filpo, Tonino Ercolino, Stefania Gelmini, Monica Mangoni, Gabriella Nesi, Constanze Hantel, Massimo Mannelli, Mario Maggi and Michaela Luconi
J. Pers. Med. 2021, 11(11), 1097; https://doi.org/10.3390/jpm11111097 - 27 Oct 2021
Cited by 6 | Viewed by 1829
Abstract
Adrenocortical carcinoma (ACC) is a rare malignancy with poor prognosis when metastatic and scarce treatment options in the advanced stages. In solid tumors, the chemokine CXCL12/CXCR4 axis is involved in the metastatic process. We demonstrated that the human adrenocortex expressed CXCL12 and its [...] Read more.
Adrenocortical carcinoma (ACC) is a rare malignancy with poor prognosis when metastatic and scarce treatment options in the advanced stages. In solid tumors, the chemokine CXCL12/CXCR4 axis is involved in the metastatic process. We demonstrated that the human adrenocortex expressed CXCL12 and its cognate receptors CXCR4 and CXCR7, not only in physiological conditions, but also in ACC, where the receptors’ expression was higher and the CXCL12 expression was lower than in the physiological conditions. In a small pilot cohort of 22 ACC patients, CXCL12 negatively correlated with tumor size, stage, Weiss score, necrosis, and mitotic activity. In a Kaplan–Meier analysis, the CXCL12 tumor expression significantly predicted disease-free, progression-free, and overall survival. In vitro treatment of the primary ACC H295R and of the metastatic MUC-1 cell line with the PPARγ-ligand rosiglitazone (RGZ) dose-dependently reduced proliferation, resulting in a significant increase in CXCL12 and a decrease in its receptors in the H295R cells only, with no effect on the MUC-1 levels. In ACC mouse xenografts, tumor growth was inhibited by the RGZ treatment before tumor development (prevention-setting) and once the tumor had grown (therapeutic-setting), similarly to mitotane (MTT). This inhibition was associated with a significant suppression of the tumor CXCR4/CXCR7 and the stimulation of human CXCL12 expression. Tumor growth correlated inversely with CXCL12 and positively with CXCR4 expression, suggesting that local CXCL12 may impair the primary tumor cell response to the ligand gradient that may contribute to driving the tumor progression. These findings indicate that CXCL12/CXCR4 may constitute a potential target for anti-cancer agents such as rosiglitazone in the treatment of ACC. Full article
(This article belongs to the Special Issue Personalized Medicine in Benign and Malignant Adrenal Tumors)
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