Prognostic predictors of adrenocortical carcinoma: A single-center thirty-year experience

Frontiers in Endocrinology

Endocrinology

Xin-Ning Ng¹  Chun-Jui Huang²  Liang-Yu Lin²  Li-Hsin Pan²  Chueh-Chuan Yen³ 

[1] Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan;Division of Endocrinology and Metabolism, Department of Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Foundation, Chiayi, Taiwan;Division of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan;Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan;Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan;Division of Clinical Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan;Division of Medical Oncology, Center for Immuno-oncology, Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan;Institute of Biopharmaceutical Sciences, College of Pharmaceutical Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan;

关键词: adrenocortical carcinoma;    mitotane;    overall survival (OS);    progression-free survival (PFS);    adrenal carcinomas;   

DOI  :  10.3389/fendo.2023.1134643

 received in 2022-12-30, accepted in 2023-02-27,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundThe prognosis of adrenocortical carcinoma (ACC) is poor but highly variable. The present study aimed to characterize patients with ACC at a single center in Taiwan and to determine the prognostic predictors of overall and progression-free survival.MethodsMedical records of patients, who were diagnosed with ACC at Taipei Veterans General Hospital between January 1992 and June 2021, were reviewed. Patient demographics, tumor characteristics, and subsequent treatment were analyzed with regard to overall survival and progression-free survival using Kaplan-Meier methods and a Cox regression model.ResultsSixty-seven patients were included. Females (65.7%) were more susceptible to ACC, with a younger onset and active hormonal secretion. One-half of the patients exhibited distant metastases at the time of diagnosis. The European Network for the Study of Adrenal Tumours (ENSAT) stage (hazard ratio [HR] 3.60 [95% confidence interval (CI) 1.25–10.38]; p=0.018), large vessel invasion (HR 5.19 [95% CI 1.75–15.37]; p=0.003), and mitotane use (HR 0.27 [95% CI 0.11–0.70]; p=0.007) were significantly associated with overall survival (OS). There was no single factor independently associated with progression-free survival.ConclusionENSAT stage had a substantial impact on overall survival though there was no difference in OS between patients with stage II and stage III ACC. Large vessel invasion portended poor prognosis and influenced OS significantly. Moreover, mitotane only improved clinical outcomes of patients with stage IV disease.

【 授权许可】

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Copyright © 2023 Pan, Yen, Huang, Ng and Lin