TY - JOUR
T1 - Adrenocortical carcinoma
T2 - Clinical outcomes and prognosis of 330 patients at a tertiary care Center
AU - Ayala-Ramirez, Montserrat
AU - Jasim, Sina
AU - Feng, Lei
AU - Ejaz, Shamim
AU - Deniz, Ferhat
AU - Busaidy, Naifa
AU - Waguespack, Steven G.
AU - Naing, Aung
AU - Sircar, Kanishka
AU - Wood, Christopher G.
AU - Pagliaro, Lance
AU - Jimenez, Camilo
AU - Vassilopoulou-Sellin, Rena
AU - Habra, Mouhammed Amir
PY - 2013/12
Y1 - 2013/12
N2 - Objective: Adrenocortical carcinoma (ACC) is a rare malignancy with a poor prognosis. Herein, we describe the clinical features and outcomes for a large series of ACC patients. Design and methods: Retrospective review of ACC patients seen at The University of Texas MDAnderson Cancer Center from 1998 through 2011. Results: A total of 330 patients with median age at diagnosis of 48.5 years; 12 (3.6%) patients were under 18 years. Hormonally functioning tumors represented 41.8% (n=138) of all cases. Surgical resection for the primary tumor was done in 275 (83.3%) patients (45 at MDAnderson (16.4%)). For those who had surgical resection, the median local-recurrence-free time was 1.04 years. Factors associated with local recurrence included positive surgical margins (P=0.007) and advanced disease stage (P=0.026). Median overall survival time for all patients was 3.21 years. Median survival times were 24.1, 6.08, 3.47, and 0.89 years for stages I, II, III, and IV respectively. In multivariable analysis, older age, functioning tumors, and higher disease stage remained significant prognostic factors associated with poor survival. Conclusion: ACC prognosis remains poor with the use of currently available treatments. Older age, functioning tumors, and incomplete resections are clinical factors associated with poor survival. Surgical expertise is important to achieve complete resections and to improve outcome.
AB - Objective: Adrenocortical carcinoma (ACC) is a rare malignancy with a poor prognosis. Herein, we describe the clinical features and outcomes for a large series of ACC patients. Design and methods: Retrospective review of ACC patients seen at The University of Texas MDAnderson Cancer Center from 1998 through 2011. Results: A total of 330 patients with median age at diagnosis of 48.5 years; 12 (3.6%) patients were under 18 years. Hormonally functioning tumors represented 41.8% (n=138) of all cases. Surgical resection for the primary tumor was done in 275 (83.3%) patients (45 at MDAnderson (16.4%)). For those who had surgical resection, the median local-recurrence-free time was 1.04 years. Factors associated with local recurrence included positive surgical margins (P=0.007) and advanced disease stage (P=0.026). Median overall survival time for all patients was 3.21 years. Median survival times were 24.1, 6.08, 3.47, and 0.89 years for stages I, II, III, and IV respectively. In multivariable analysis, older age, functioning tumors, and higher disease stage remained significant prognostic factors associated with poor survival. Conclusion: ACC prognosis remains poor with the use of currently available treatments. Older age, functioning tumors, and incomplete resections are clinical factors associated with poor survival. Surgical expertise is important to achieve complete resections and to improve outcome.
UR - http://www.scopus.com/inward/record.url?scp=84888267331&partnerID=8YFLogxK
U2 - 10.1530/EJE-13-0519
DO - 10.1530/EJE-13-0519
M3 - Article
C2 - 24086089
AN - SCOPUS:84888267331
SN - 0804-4643
VL - 169
SP - 891
EP - 899
JO - European Journal of Endocrinology
JF - European Journal of Endocrinology
IS - 6
ER -