Kara K Rossfeld1, Shishir K Maithel2, Jason Prescott3, Tracy S Wang4, Ryan C Fields5, Sharon M Weber6, Jason K Sicklick7, Adam C Yopp8, Quan-Yang Duh9, Carmen C Solorzano10, Konstantinos I Votanopoulos11, Ioannis Hatzaras12, George A Poultsides13, Lawrence A Shirley1. 1. Division of Surgical Oncology, Department of Surgery, The Ohio State University, Columbus, Ohio. 2. Division of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, Georgia. 3. Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland. 4. Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin. 5. Department of Surgery, Washington University School of Medicine, St. Louis, Missouri. 6. Department of General Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin. 7. Department of Surgery, University of California San Diego, San Diego, California. 8. Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas. 9. Department of Surgery, University of California San Francisco, San Francisco, California. 10. Division of Surgical Oncology, Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee. 11. Department of Surgery, Wake Forest School of Medicine, Winston-Salem, North Carolina. 12. Department of Surgery, New York University School of Medicine, New York, New York. 13. Department of Surgery, Stanford University School of Medicine, Stanford, California.
Abstract
BACKGROUND AND OBJECTIVES: Little is known regarding the difference in prognosis among patients who have an incidentally discovered adrenocortical carcinoma (ACC) vs those who present with signs or symptoms. We aimed to explore differences in the outcomes of these two populations. METHODS: Data were collected on patients who underwent resection of ACC at 1 of 13 institutions between January 1993 and December 2014. Presentations were categorized as incidental vs symptomatic and outcomes were compared. RESULTS: Among 227 patients, 100 were diagnosed incidentally while 127 patients presented with symptoms/signs. Clinical and pathological features were comparable among incidental vs nonincidental patients with ACC following the exceptions. Patients with incidentalomas were more likely to have a T1/T2 tumor (55.8% vs 34.8%; P < 0.01) and less likely to have a functional tumor (33.7% vs 47.9%; P = 0.04). Patients with an incidental ACC had improved median recurrence-free survival (RFS; 29.4 months) compared with patients with a nonincidental ACC (13.0 months; P = 0.03); however, on multivariable analysis, incidental ACC was not an independent predictor of survival. CONCLUSIONS: Patients with resected ACC identified incidentally had an improved RFS compared with the patients who presented with symptoms or signs. This difference may be related to the patients with incidental tumors having earlier T-stage disease.
BACKGROUND AND OBJECTIVES: Little is known regarding the difference in prognosis among patients who have an incidentally discovered adrenocortical carcinoma (ACC) vs those who present with signs or symptoms. We aimed to explore differences in the outcomes of these two populations. METHODS: Data were collected on patients who underwent resection of ACC at 1 of 13 institutions between January 1993 and December 2014. Presentations were categorized as incidental vs symptomatic and outcomes were compared. RESULTS: Among 227 patients, 100 were diagnosed incidentally while 127 patients presented with symptoms/signs. Clinical and pathological features were comparable among incidental vs nonincidental patients with ACC following the exceptions. Patients with incidentalomas were more likely to have a T1/T2 tumor (55.8% vs 34.8%; P < 0.01) and less likely to have a functional tumor (33.7% vs 47.9%; P = 0.04). Patients with an incidental ACC had improved median recurrence-free survival (RFS; 29.4 months) compared with patients with a nonincidental ACC (13.0 months; P = 0.03); however, on multivariable analysis, incidental ACC was not an independent predictor of survival. CONCLUSIONS:Patients with resected ACC identified incidentally had an improved RFS compared with the patients who presented with symptoms or signs. This difference may be related to the patients with incidental tumors having earlier T-stage disease.
Authors: Lekha Madhavan Nair; K M Jagathnath Krishna; Aswin Kumar; Susan Mathews; John Joseph; Francis Vadakkumparambil James Journal: Indian J Urol Date: 2019 Jul-Sep
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