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Early Detection of Recurrence and Progress Using Serum Steroid Profiling by LC–MS/MS in Patients with Adrenocortical Carcinoma

Authors :
Otilia Kimpel
Barbara Altieri
Ulrich Dischinger
Carmina Teresa Fuss
Max Kurlbaum
Martin Fassnacht
Source :
Metabolites, Vol 14, Iss 1, p 20 (2023)
Publication Year :
2023
Publisher :
MDPI AG, 2023.

Abstract

Serum liquid chromatography–tandem mass spectrometry (LC–MS/MS) steroid profiling is used for the diagnosis of adrenocortical carcinoma (ACC). Guidelines recommend endocrine work-up in addition to radiological imaging for follow-up in ACC, but data on this topic are scarce. Patients were included in this retrospective study if pre-therapeutic hormone values, regular tumour evaluation by imaging, steroid measurements by LC–MS/MS, and details on therapies were available. The utility of steroid profiles in detecting recurrence or disease progression was assessed, whereby “endocrine progress” was defined by an elevation of at least 3 of 13 analysed hormones. Cohort A included 47 patients after R0 resection, of whom 15 experienced recurrence and 32 did not. In cohort B, 52 patients with advanced disease (including 7 patients of cohort A with recurrence) could be evaluated on 74 visits when progressive disease was documented. In 20 of 89 cases with documented disease progression, “endocrine progress” was detectable prior to radiological progress. In these cases, recurrence/progression was detected at a median of 32 days earlier by steroid measurement than by imaging, with 11-deoxycortisol and testosterone being the most sensitive markers. Notably, these patients had significantly larger tumour burden. In conclusion, steroid profiling by LC–MS/MS is of value in detecting recurrent/progressive disease in ACC.

Details

Language :
English
ISSN :
22181989
Volume :
14
Issue :
1
Database :
Directory of Open Access Journals
Journal :
Metabolites
Publication Type :
Academic Journal
Accession number :
edsdoj.8fb87aa6fbf040a0b8d7c078ae73e5c6
Document Type :
article
Full Text :
https://doi.org/10.3390/metabo14010020