Preoperative adrenal biopsy does not affect overall survival in adrenocortical carcinoma

2017 ◽  
Vol 214 (4) ◽  
pp. 748-751 ◽  
Author(s):  
Paritosh Suman ◽  
Natalie Calcatera ◽  
Chi-Hsiung Wang ◽  
Tricia A. Moo-Young ◽  
David J. Winchester ◽  
...  
Keyword(s):  
Overall Survival ◽  
Adrenocortical Carcinoma ◽  
Adrenal Biopsy

scholarly journals Transcutaneous biopsy of adrenocortical carcinoma is rarely helpful in diagnosis, potentially harmful, but does not affect patient outcome

2014 ◽  
Vol 170 (6) ◽  
pp. 829-835 ◽  
Author(s):  
Andrew R Williams ◽  
Gary D Hammer ◽  
Tobias Else
Keyword(s):  
Patient Outcome ◽  
Overall Survival ◽  
Adrenocortical Carcinoma ◽  
Stage I ◽  
Adrenal Biopsy ◽  
Significant Difference ◽  
Adrenal Masses ◽  
Affect Patient Outcome ◽  
Rare Malignancy ◽  
The University

ContextAdrenocortical carcinoma (ACC) is a rare malignancy with high recurrence and mortality rates. The utility, sensitivity, and effect on patient outcome of transcutaneous adrenal biopsy (TAB) for single, large, adrenal masses are unclear.ObjectiveThis study evaluated the utility, diagnostic sensitivity, and effect on patient outcome of TAB in patients with ACC.Design and settingWe conducted a retrospective review of the electronic medical records of all ACC patients who were evaluated at the University of Michigan Health System from 1991 to 2011. We evaluated the sensitivity of TAB for tumors with the final pathological diagnosis of ACC. We compared the characteristics and survival of patients with stage I–III disease who underwent TAB with those who did not undergo TAB.ResultsA total of 75 ACC patients with TAB were identified. Complications occurred in at least 11% of patients and were mainly associated with bleeding. The maximum sensitivity of the procedure in diagnosing ACC was 70%. For stage I–III patients, baseline characteristics, stage at diagnosis, and adjuvant treatment with mitotane or radiation were not significantly different between the TAB (n=36) and the non-TAB (n=254) groups. There was no significant difference in recurrence-free (P=0.7) or overall survival (P=0.7) between patients who underwent TAB and those who did not.ConclusionsTAB of single, large, adrenal masses is usually unnecessary, exposes patients to risk, but does not affect recurrence-free or overall survival.

scholarly journals Survival Predictors of Metastatic Adrenocortical Carcinoma: a SEER-based Retrospective Study

2021 ◽  
Author(s):  
Ningning Yang ◽  
Qingqing Wang ◽  
Fengxia Chen ◽  
Haibin Ou ◽  
Yangyang Zeng ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Liver Metastasis ◽  
Adrenocortical Carcinoma ◽  
Poor Prognosis ◽  
Lung Metastases ◽  
Multivariable Analysis ◽  
Survival Outcome ◽  
Metastatic Site ◽  
Survival Predictors

Abstract Background: Metastatic adrenocortical carcinomas (MAC) have a poor prognosis. Advanced adrenocortical carcinoma often metastasizes to lung and liver. Prognostic factors of MAC have been rarely reported. This study aims to identify the association between specific metastasis and overall survival (OS) in MAC and determine the survival predictors for MAC patients.Methods: MAC patients' data was obtained from Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2016. Survival differences were analyzed by Kaplan–Meier analysis and log-rank tests. Cox proportional hazard model was used to identify the prognostic factors associated with overall survival.Results: A total of 152 MAC patients were selected, among whom 77 patients (50.7%) were diagnosed with one metastatic site, 75 (49.3%) diagnosed with more than one distant metastasis. For the whole MAC cohort, multivariable analysis showed that year of diagnosis between 2013 and 2016, without liver metastasis, surgery and chemotherapy were significantly favorable predictors of OS. For patients with one metastatic site, lung metastases had a better survival outcome than liver metastases(p=0.037). Besides, compared with patients who didn’t received surgery, patients underwent surgery were correlated with longer OS (p=0.004). For patients with more than one site of distant metastases, married status, surgery, and chemotherapy predicted a better OS. Radiotherapy did not improve overall survival outcomes in the three cohort.Conclusion: Liver metastasis has a poor prognosis. Year of diagnosis, metastatic sites, surgery and chemotherapy were significant prognostic factors for OS in MAC patients. For patients with single metastasis, surgery was a favorable prognostic factor, while married patients, surgery and chemotherapy predicted a better survival outcome in patients with more than one metastasis. Based on the collective findings, surgery can be regarded as the preferred treatment option for all MAC patients. Besides, chemotherapy is also a good choice for patients with multiple metastases.

scholarly journals Nomograms to predict overall survival and cancer-specific survival in patients with adrenocortical carcinoma

2018 ◽  
Vol Volume 10 ◽  
pp. 6949-6959 ◽  
Author(s):  
Yan Li ◽  
Xiaohui Bian ◽  
Junyu Ouyang ◽  
Shuyi Wei ◽  
Meizhi He ◽  
...  
Keyword(s):  
Overall Survival ◽  
Adrenocortical Carcinoma ◽  
Cancer Specific Survival

scholarly journals Adjuvant Radiation Improves Recurrence-Free Survival and Overall Survival in Adrenocortical Carcinoma

2019 ◽  
Vol 104 (9) ◽  
pp. 3743-3750 ◽  
Author(s):  
Laila A Gharzai ◽  
Michael D Green ◽  
Kent A Griffith ◽  
Tobias Else ◽  
Charles S Mayo ◽  
...  
Keyword(s):  
Overall Survival ◽  
Adrenocortical Carcinoma ◽  
Adjuvant Radiation ◽  
Recurrence Free Survival ◽  
University Of Michigan ◽  
Free Survival ◽  
Tumor Bed ◽  
Distant Failure ◽  
Rare Malignancy ◽  
The University

Abstract Context Adrenocortical carcinoma (ACC) is a rare malignancy with high rates of recurrence and poor prognosis. The role of radiotherapy (RT) in localized ACC has been controversial, and RT is not routinely offered. Objective To evaluate the benefit of adjuvant RT on outcomes in ACC. Design This is a retrospective propensity-matched analysis. Setting All patients were seen through the University of Michigan’s Endocrine Oncology program, and all those who underwent RT were treated at the University of Michigan. Participants Of 424 patients with ACC, 78 were selected; 39 patients underwent adjuvant radiation. Intervention Adjuvant RT to the tumor bed and adjacent lymph nodes. Main Outcomes Measures Time to local failure, distant failure, or death. Results Median follow-up time was 4.21 years (95% CI, 2.79 to 4.94). The median radiation dose was 55 Gy (range, 45 to 60). The 3-year overall survival estimate for patients improved from 48.6% for patients without RT (95% CI, 29.7 to 65.2) to 77.7% (95% CI, 56.3 to 89.5) with RT, with a hazard ratio (HR) of 3.59 (95% CI, 1.60 to 8.09; P = 0.002). RT improved local recurrence-free survival (RFS) from 34.2% (95% CI, 18.8 to 50.3) to 59.5% (95% CI, 39.0 to 75.0), with an HR of 2.67 (95% CI, 1.38 to 5.19; P = 0.0035). RT improved all RFS from 18.3% (95% CI, 6.7 to 34.3) to 46.7% (95% CI, 26.9 to 64.3), with an HR 2.59 (95% CI, 1.40 to 4.79; P = 0.0024). Conclusions In the largest single institution study to date, adjuvant RT after gross resection of ACC improved local RFS, all RFS, and overall survival in this propensity-matched analysis. Adjuvant RT should be considered a part of multidisciplinary management for patients with ACC.

scholarly journals A Transcription Factor Signature Predicts Prognosis of Patients with Adrenocortical Carcinoma

2021 ◽  
Author(s):  
Jianyu Zhao ◽  
Bo Liu ◽  
Xiaoping Li
Keyword(s):  
Overall Survival ◽  
High Risk ◽  
Risk Score ◽  
Adrenocortical Carcinoma ◽  
Cox Regression ◽  
Risk Group ◽  
High Risk Group ◽  
Prognostic Signature ◽  
Abdominal Masses ◽  
Cox Analysis

Abstract Background: Adrenocortical carcinoma (ACC) is a rare endocrine cancer that manifests as abdominal masses and excessive steroid hormone levels. Transcription factors (TFs) deregulation is found to be involved in adrenocortical tumorigenesis and cancer progression. This study aimed to construct a TF-based prognostic signature for prediction of survival of ACC patients.Methods: The gene expression profile for ACC patients were downloaded from TCGA and GEO datasets. The univariate Cox analysis was applied to identify survival-related TFs and the LASSO Cox regression was conducted to construct the TF signature. The multivariate analysis was used to reveal the independent prognostic factors.Results: We identified a 13-TF prognostic signature comprised of CREB3L3, NR0B1, CENPA, FOXM1, E2F2, MYBL2, HOXC11, ZIC2, ZNF282, DNMT1, TCF3, ELK4, and KLF6 using the univariate Cox analysis and LASSO Cox regression. The risk score based on the TF-signature could classify patients into low- and high-risk group. Kaplan-Meier analyses showed that patients in the high-risk group had significantly shorter overall survival compared to the low-risk patients. ROC curves showed that the prognostic signature predicted the overall survival of ACC patients with good sensitivity and specificity. Furthermore, the TF-risk score was an independent prognostic factor.Conclusion: Taken together, we identified a 13-TF prognostic marker to predict overall survival in ACC patients.

scholarly journals Adjuvant mitotane therapy is beneficial in non-metastatic adrenocortical carcinoma at high risk of recurrence

2019 ◽  
Vol 180 (6) ◽  
pp. 387-396 ◽  
Author(s):  
A Calabrese ◽  
V Basile ◽  
S Puglisi ◽  
P Perotti ◽  
A Pia ◽  
...  
Keyword(s):  
Overall Survival ◽  
High Risk ◽  
Adrenocortical Carcinoma ◽  
Hormone Secretion ◽  
Treated Group ◽  
Stage Iii ◽  
Ki67 Index ◽  
Risk Of Recurrence ◽  
Risk Of Death ◽  
Predictors Of Response

Objective Many patients with adrenocortical carcinoma (ACC) suffer from tumor recurrence despite radical surgery. Evidence on the post-operative use of mitotane is controversial and no predictors of response are available. We aimed to assess whether adjuvant mitotane treatment may prolong survival in patients with non-metastatic ACC following complete resection and whether ACC patients at high risk of recurrence may benefit from treatment. Design and methods We retrospectively reviewed data from 152 non-metastatic ACC patients followed at the San Luigi Gonzaga Hospital: 100 patients were treated with adjuvant mitotane and 52 patients were left untreated following surgery. We assessed a number of potential predictive factors of recurrence and death. Mitotane effect was explored stratifying patients by staging (stage I–II vs stage III), hormone secretion (yes vs no) and Ki67 index. Results The non-treated group had a higher risk of recurrence (HR: 2.79, 95%CI: 1.58–4.91; P < 0.001) than mitotane-treated group, while overall survival was not significantly different between groups. Hormone secretion, elevated Weiss score and elevated Ki67 index confer a higher risk of both recurrence and death and stage III ACC of death. Adjuvant mitotane treatment reduced significantly the risk of death in patients with elevated Ki67 index (P = 0.005) and in patients with stage III ACC (P = 0.02). Conclusions Adjuvant mitotane may prolong recurrence-free survival in radically resected ACC patients with acceptable toxicity and may also prolong overall survival in a subgroup of ACC patients at high risk of recurrence.

scholarly journals A Transcription Factor Signature Predicts Prognosis of Patients with Adrenocortical Carcinoma

2021 ◽  
Author(s):  
Jianyu Zhao ◽  
Bo Liu ◽  
Xiaoping Li
Keyword(s):  
Overall Survival ◽  
High Risk ◽  
Cancer Progression ◽  
Risk Score ◽  
Adrenocortical Carcinoma ◽  
Cox Regression ◽  
Risk Group ◽  
High Risk Group ◽  
Prognostic Signature ◽  
Abdominal Masses

Abstract Background: Adrenocortical carcinoma (ACC) is a rare endocrine cancer that manifests as abdominal masses and excessive steroid hormone levels. Transcription factors (TFs) deregulation is found to be involved in adrenocortical tumorigenesis and cancer progression. This study aimed to construct a TF-based prognostic signature for prediction of survival of ACC patients.Results: We identified a 13-TF prognostic signature comprised of CREB3L3, NR0B1, CENPA, FOXM1, E2F2, MYBL2, HOXC11, ZIC2, ZNF282, DNMT1, TCF3, ELK4, and KLF6 using the univariate Cox analysis and LASSO Cox regression. The risk score based on the TF-signature could classify patients into low- and high-risk group. Kaplan-Meier analyses showed that patients in the high-risk group had significantly shorter overall survival compared to the low-risk patients. ROC curves showed that the prognostic signature predicted the overall survival of ACC patients with good sensitivity and specificity. Furthermore, the TF-risk score was an independent prognostic factor.Conclusion: Taken together, we identified a 13-TF prognostic marker to predict overall survival in ACC patients.

scholarly journals Prognostic factors of recurrence-free and overall survival in 52 patients with adrenocortical carcinoma

2016 ◽  
Author(s):  
Karolina M. Nowak ◽  
Radoslaw Samsel ◽  
Andrzej Cichocki ◽  
Katarzyna Roszkowska-Purska ◽  
Anna Kasperlik-Zaluska ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Adrenocortical Carcinoma

scholarly journals A transcription factor signature predicts prognosis of patients with adrenocortical carcinoma

2020 ◽  
Author(s):  
Jianyu Zhao ◽  
Bo Liu ◽  
Xiaoping Li
Keyword(s):  
Overall Survival ◽  
High Risk ◽  
Cancer Progression ◽  
Risk Score ◽  
Adrenocortical Carcinoma ◽  
Cox Regression ◽  
Risk Group ◽  
High Risk Group ◽  
Prognostic Signature ◽  
Abdominal Masses

Abstract Background Adrenocortical carcinoma (ACC) is a rare endocrine cancer that manifests as abdominal masses and excessive steroid hormone levels. Transcription factors (TFs) deregulation is found to be involved in adrenocortical tumorigenesis and cancer progression. This study aimed to construct a TF-based prognostic signature for prediction of survival of ACC patients. Methods The gene expression profile for ACC patients were downloaded from TCGA and GEO datasets. The univariate Cox analysis was applied to identify survival-related TFs and the LASSO Cox regression was conducted to construct the TF signature. The multivariate analysis was used to reveal the independent prognostic factors. Results We identified a 13-TF prognostic signature comprised of CREB3L3, NR0B1, CENPA, FOXM1, E2F2, MYBL2, HOXC11, ZIC2, ZNF282, DNMT1, TCF3, ELK4, and KLF6. The risk score based on the TF-signature could classify patients into low- and high-risk group. Kaplan-Meier analyses showed that patients in the high-risk group had significantly shorter overall survival compared to the low-risk patients. ROC curves showed that the prognostic signature predicted the overall survival of ACC patients with good sensitivity and specificity. Furthermore, the TF-risk score was an independent prognostic factor. Conclusions Taken together, we identified a 13-TF prognostic marker to predict overall survival in ACC patients.

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