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.
Demographic and clinical characteristics of prevention-eligible patients with migraine in the US: A linked national survey and administrative claims database study
