Sri Harsha Tella1, Anuhya Kommalapati2, Subhashini Yaturu3, Electron Kebebew4. 1. Department of Medicine, Division of Endocrinology, Diabetes and Metabolism, University of South Carolina School of Medicine, Columbia, South Carolina. 2. Department of Internal Medicine, University of South Carolina School of Medicine, Columbia, South Carolina. 3. Division of Endocrinology, Wm. Jennings Bryan Dorn VA Medical Center, Columbia, South Carolina. 4. Department of Surgery and Stanford Cancer Center, School of Medicine, Stanford University, Stanford, California.
Abstract
Context: Adrenocortical carcinoma (ACC) is rare; knowledge about prognostic factors and survival outcomes is limited. Objective: To describe predictors of survival and overall survival (OS) outcomes. Design and Patients: Retrospective analysis of data from the National Cancer Database (NCDB) from 2004 to 2015 on 3185 patients with pathologically confirmed ACC. Main Outcome Measures: Baseline description, survival outcomes, and predictors of survival were evaluated in patients with ACC. Results: Median age at ACC diagnosis was 55 (range: 18 to 90) years; did not differ significantly by sex or stage of the disease at diagnosis. On multivariate analysis, increasing age, higher Charlson-Deyo comorbidity index score, high tumor grade, and no surgical therapy (all P < 0.0001); and stage IV disease (P = 0.002) and lymphadenectomy during surgery (P = 0.02) were associated with poor prognosis. Patients with stage I-III disease treated with surgical resection had significantly better median OS (63 vs 8 months; P < 0.001). In stage IV disease, better median OS occurred in patients treated with surgery (19 vs 6 months; P < 0.001), and postsurgical radiation (29 vs 10 months; P < 0.001) or chemotherapy (22 vs 13 months; P = 0.004). Conclusion: OS varied with increasing age, higher comorbidity index, grade, and stage of ACC at presentation. There was improved survival with surgical resection of primary tumor, irrespective of disease stage; postsurgical chemotherapy or radiation was of benefit only in stage IV disease.
Context:Adrenocortical carcinoma (ACC) is rare; knowledge about prognostic factors and survival outcomes is limited. Objective: To describe predictors of survival and overall survival (OS) outcomes. Design and Patients: Retrospective analysis of data from the National Cancer Database (NCDB) from 2004 to 2015 on 3185 patients with pathologically confirmed ACC. Main Outcome Measures: Baseline description, survival outcomes, and predictors of survival were evaluated in patients with ACC. Results: Median age at ACC diagnosis was 55 (range: 18 to 90) years; did not differ significantly by sex or stage of the disease at diagnosis. On multivariate analysis, increasing age, higher Charlson-Deyo comorbidity index score, high tumor grade, and no surgical therapy (all P < 0.0001); and stage IV disease (P = 0.002) and lymphadenectomy during surgery (P = 0.02) were associated with poor prognosis. Patients with stage I-III disease treated with surgical resection had significantly better median OS (63 vs 8 months; P < 0.001). In stage IV disease, better median OS occurred in patients treated with surgery (19 vs 6 months; P < 0.001), and postsurgical radiation (29 vs 10 months; P < 0.001) or chemotherapy (22 vs 13 months; P = 0.004). Conclusion: OS varied with increasing age, higher comorbidity index, grade, and stage of ACC at presentation. There was improved survival with surgical resection of primary tumor, irrespective of disease stage; postsurgical chemotherapy or radiation was of benefit only in stage IV disease.
Authors: Reed I Ayabe; Raja R Narayan; Samantha M Ruff; Michael M Wach; Winifred Lo; Pieter M H Nierop; Seth M Steinberg; R Taylor Ripley; Jeremy L Davis; Bas G Koerkamp; Michael I D'Angelica; T Peter Kingham; William R Jarnagin; Jonathan M Hernandez Journal: HPB (Oxford) Date: 2019-08-22 Impact factor: 3.647
Authors: Salvatore Grisanti; Deborah Cosentini; Marta Laganà; Alessandra Morandi; Barbara Lazzari; Laura Ferrari; Alberto Dalla Volta; Roberta Ambrosini; Vittorio Domenico Ferrari; Sandra Sigala; Alfredo Berruti Journal: Front Endocrinol (Lausanne) Date: 2021-02-24 Impact factor: 5.555
Authors: Michal Mauda-Havakuk; Elizabeth Levin; Elliot B Levy; Venkatesh P Krishnasamy; Victoria Anderson; Nidhi Jain; Hayet Amalou; Tito Fojo; Maureen Edgerly; Paul G Wakim; Marybeth S Hughes; Jaydira Del Rivero; Bradford J Wood Journal: Cancer Med Date: 2021-03-09 Impact factor: 4.711
Authors: Rui Caetano Oliveira; Maria João Martins; Carolina Moreno; Rui Almeida; João Carvalho; Paulo Teixeira; Miguel Teixeira; Edgar Tavares Silva; Isabel Paiva; Arnaldo Figueiredo; Maria Augusta Cipriano Journal: Rare Tumors Date: 2021-06-27
Authors: Reed I Ayabe; Michael M Wach; Samantha M Ruff; Laurence P Diggs; Sean P Martin; Timothy Wiemken; Leslie Hinyard; Jeremy L Davis; Carrie Luu; Jonathan M Hernandez Journal: J Surg Oncol Date: 2020-06-08 Impact factor: 2.885