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We randomized 96 postmenopausal women with metastatic breast carcinoma to receive surgical adrenalectomy or medical therapy with an adrenal inhibitor, aminoglutethimide (AG), plus replacement hydrocortisone. Before randomization, women were stratified according to disease-free interval, site of dominant disease, and estrogen-receptor status. Of 40 evaluable women treated with AG and hydrocortisone, 53 per cent had objective responses, as compared with 45 per cent of 29 women undergoing surgical adrenalectomy (P value not significant). Responses lasted a mean of 17.2 months in the medical group and greater than 17.1 months in the surgical group (not significant). Estrogen levels fell similarly in response to either treatment, whereas AG and hydrocortisone preserved androgen production. A null hypothesis tested the single question asked by this study: "Is surgical adrenalectomy superior to treatment with AG and hydrocortisone?" Rejection at significance levels of P = 0.01 and P = 0.07 for differences of 20 per cent and 10 per cent, respectively, suggested that medical therapy with AG and hydrocortisone may be logically chosen in place of surgical adrenalectomy.
R J Santen, and
T J Worgul, and
E Samojlik, and
A Interrante, and
A E Boucher, and
A Lipton, and
H A Harvey, and
D S White, and
E Smart, and
C Cox, and
S A Wells
July 1987,
Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology,
R J Santen, and
T J Worgul, and
E Samojlik, and
A Interrante, and
A E Boucher, and
A Lipton, and
H A Harvey, and
D S White, and
E Smart, and
C Cox, and
S A Wells
January 1986,
Breast cancer research and treatment,
R J Santen, and
T J Worgul, and
E Samojlik, and
A Interrante, and
A E Boucher, and
A Lipton, and
H A Harvey, and
D S White, and
E Smart, and
C Cox, and
S A Wells
January 1982,
The New England journal of medicine,
R J Santen, and
T J Worgul, and
E Samojlik, and
A Interrante, and
A E Boucher, and
A Lipton, and
H A Harvey, and
D S White, and
E Smart, and
C Cox, and
S A Wells
June 1986,
Journal of clinical oncology : official journal of the American Society of Clinical Oncology,
R J Santen, and
T J Worgul, and
E Samojlik, and
A Interrante, and
A E Boucher, and
A Lipton, and
H A Harvey, and
D S White, and
E Smart, and
C Cox, and
S A Wells
February 1981,
The Medical journal of Australia,
R J Santen, and
T J Worgul, and
E Samojlik, and
A Interrante, and
A E Boucher, and
A Lipton, and
H A Harvey, and
D S White, and
E Smart, and
C Cox, and
S A Wells
January 1986,
Anticancer research,
R J Santen, and
T J Worgul, and
E Samojlik, and
A Interrante, and
A E Boucher, and
A Lipton, and
H A Harvey, and
D S White, and
E Smart, and
C Cox, and
S A Wells
September 1988,
Journal of the National Cancer Institute,
R J Santen, and
T J Worgul, and
E Samojlik, and
A Interrante, and
A E Boucher, and
A Lipton, and
H A Harvey, and
D S White, and
E Smart, and
C Cox, and
S A Wells
February 1987,
American journal of clinical oncology,
R J Santen, and
T J Worgul, and
E Samojlik, and
A Interrante, and
A E Boucher, and
A Lipton, and
H A Harvey, and
D S White, and
E Smart, and
C Cox, and
S A Wells
January 1981,
Breast cancer research and treatment,
R J Santen, and
T J Worgul, and
E Samojlik, and
A Interrante, and
A E Boucher, and
A Lipton, and
H A Harvey, and
D S White, and
E Smart, and
C Cox, and
S A Wells
January 2010,
Annals of oncology : official journal of the European Society for Medical Oncology,
