1. Prognostic factors in stage III-IV adrenocortical carcinomas (ACC): an European Network for the Study of Adrenal Tumor (ENSAT) study
- Author
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Libé, R., Borget, I., Ronchi, C.L., Zaggia, B., Kroiss, M., Kerkhofs, T., Bertherat, J., Volante, M., Quinkler, M., Chabre, O., Bala, M., Tabarin, A., Beuschlein, F., Vezzosi, D., Deutschbein, T., Borson-Chazot, F., Hermsen, I., Stell, A., Fottner, C., Leboulleux, S., Hahner, S., Mannelli, M., Berruti, A., Haak, H., Terzolo, M., Fassnacht, M., Baudin, E., ENSAT Network, the, Interne Geneeskunde, RS: CAPHRI School for Public Health and Primary Care, and Health Services Research
- Subjects
Male ,Lung Neoplasms ,ENSAT ,Gastroenterology ,PROPOSAL ,Clinical endpoint ,Adrenocortical carcinoma ,ENDOCRINE ,Stage (cooking) ,Liver Neoplasms ,Intraventricular block ,Hematology ,Middle Aged ,SERIES ,CANCER ,Europe ,Survival Rate ,Oncology ,medicine.vein ,Lymphatic Metastasis ,SURVIVAL ,Female ,medicine.medical_specialty ,UNITED-STATES ,Bone Neoplasms ,Inferior vena cava ,Internal medicine ,GRAS ,medicine ,adrenocortical carcinoma ,Prognostic factors, adrenocortical carcinoma ,Humans ,Neoplasm Invasiveness ,Survival rate ,Prognostic factors ,Neoplasm Staging ,Retrospective Studies ,business.industry ,Cancer ,prognostic factors ,Retrospective cohort study ,medicine.disease ,Adrenal Cortex Neoplasms ,Surgery ,Adrenocortical carcinoma, prognosis ,prognosis ,Neoplasm Grading ,Neoplasm Recurrence, Local ,business ,Follow-Up Studies - Abstract
Background: The clinical course of advanced adrenocortical carcinoma (ACC) is heterogeneous. Our study aimed primarily to refine and make headway in the prognostic stratification of advanced ACC.Patients and methods: Patients with advanced ENSAT ACC (stage III or stage IV) at diagnosis registered between 2000 and 2009 in the ENSAT database were enrolled. The primary end point was overall survival (OS). Parameters of potential prognostic relevance were selected. Univariate and multivariate analyses were carried out: model 1 'before surgery'; model 2 'post-surgery'.Results: Four hundred and forty-four patients with advanced ENSAT ACC (stage III: 210; stage IV: 234) were analyzed. After a median follow-up of 55.2 months, the median OS was 24 months. A modified ENSAT (mENSAT) classification was validated: stage III (invasion of surrounding tissues/organs or the vena renalis/cava) and stage IVa, IVb, IVc (2, 3 or > 3 metastatic organs, including N, respectively). Two-or 5-year OS was 73%, 46%, 26% and 15% or 50%, 15%, 14% and 2% for stages III, IVa, IVb and IVc, respectively. In the multivariate analysis, mENSAT stages (stages IVa, IVb, or IVc, respectively) were significantly correlated with OS (P = 50 years (P 6 and/or Ki67 >= 20%, P = 0.06) in model 2.Conclusion: The mENSAT classification and GRAS parameters (Grade, R status, Age and Symptoms) were found to best stratify the prognosis of patients with advanced ACC.
- Published
- 2015