Diagnosis, treatment, and survival analysis of adrenocortical carcinomas: a multicentric study

• Type: Article in International Scientific Journal
• Date: 2020

Authors

Souteiro, P (Author) Other; Donato, S (Author) Other; Costa, C (Author) Other; Pereira, CA (Author) Other; Simoes Pereira, J (Author) Other; Oliveira, J (Author) Other; Belo, S (Author) Other; Santos, AP (Author) Other; Cardoso, H (Author) Other; Leite, V (Author) Other; Carvalho, Davide (Author) FMUP; Torres, I (Author) Other

Journal

Title: HORMONES-INTERNATIONAL JOURNAL OF ENDOCRINOLOGY AND METABOLISM

Vol. 19

Pages: 197-203

ISSN: 1109-3099

Indexing

ISI Web of Knowledge - 7 Citations

Scopus - 7 Citations

Other information

Authenticus ID: P-00R-GTC

DOI: 10.1007/s42000-019-00161-1

Abstract (EN): Introduction Current guidelines specify controversial areas in adrenocortical carcinomas (ACC), such as optimal follow-up time after remission and identification of prognostic markers. We aim to address these topics by analyzing four reference centers in our country. Methods Cross-sectional multicentric study of 69 patients (mean age: 51.7 +/- 16.7 years-old; women, 72.5%). Kaplan-Meier survival curves and Cox regression analysis were used to calculate overall survival and its predictors. Results Thirty-eight individuals (55.0%) had hormonal autonomous production, and 40.6% of the patients presented with metastasis. Surgery was performed in 84.1% of them. Most of these patients (72.4%) were then assigned to adjuvant therapy, while 27.6% were actively surveilled. Among patients undergoing surgery, those who achieved transient remission presented a longer survival time (66 months) than those who never reached the disease-free status (21 months) (p = 0.021). One patient presented with recurrence more than 7 years after complete tumor resection. The lowest overall survival was observed in patients (n = 11) assigned to palliative care since diagnosis (9 months). Tumor stage was identified as the only independent predictor of survival in our cohort (p = 0.006). Five-year survival was 67% for tumors confined to the adrenal space (stage I/II), 56% for locally advanced disease (stage III), and 0% for metastatic disease (stage IV). Conclusion This study reinforces the dismal prognosis of ACC, the need for long-term follow-up, and tumor stage as the most important survival predictor. Reviewing medical records in such rare conditions is an opportunity to identify insufficiencies and to improve medical care.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 7