New Findings on Presentation and Outcome of Patients With Adrenocortical Cancer: Results From a National Cohort Study
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Le résumé fourni par la source
CONTEXT: Because of the rarity of adrenocortical cancer (ACC), only a few population-based studies are available, and they reported limited details in the characterization of patients and their treatment. OBJECTIVE: To describe in a nationwide cohort the presentation of patients with ACC, treatment strategies, and potential prognostic factors. METHODS: Retrospective analysis of 512 patients with ACC, diagnosed in 12 referral centers in Italy from January 1990 to June 2018. RESULTS: ACC diagnosed as incidentalomas accounted for overall 38.1% of cases, with a frequency that increases with age and with less aggressive pathological features than symptomatic tumors. Women (60.2%) were younger than men and had smaller tumors, which more frequently secreted hormones. Surgery was mainly done with an open approach (72%), and after surgical resection, 62.7% of patients started adjuvant mitotane therapy. Recurrence after tumor resection occurred in 56.2% of patients. In patients with localized disease, cortisol secretion, ENSAT stage III, Ki67%, and Weiss score were associated with an increased risk of recurrence, whereas margin-free resection, open surgery, and adjuvant mitotane treatment were associated with reduced risk. Death occurred in 38.1% of patients and recurrence-free survival (RFS) predicted overall survival (OS). In localized disease, age, cortisol secretion, Ki67%, ENSAT stage III, and recurrence were associated with increased risk of mortality. ACCs presenting as adrenal incidentalomas showed prolonged RFS and OS. CONCLUSION: Our study shows that ACC is a sex-related disease and demonstrates that an incidental presentation is associated with a better outcome. Given the correlation between RFS and OS, RFS may be used as a surrogate endpoint in clinical studies.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- New Findings on Presentation and Outcome of Patients With Adrenocortical Cancer: Results From a National Cohort Study
- Date Crossref
- 06/04/2023
- Éditeur
- The Endocrine Society
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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University of Turin Department of Clinical and Biological Sciences pays non établi dans la noticeUniversité ou école supérieure
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University of Messina pays non établi dans la noticeUniversité ou école supérieure
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University of Brescia Oncology Unit pays non établi dans la noticeUniversité ou école supérieure
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University of Padua Unit of Biostatistics pays non établi dans la noticeUniversité ou école supérieure
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University of Bologna Department of Medical and Surgical Sciences (DIMEC) pays non établi dans la noticeUniversité ou école supérieure
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Sapienza University of Rome pays non établi dans la noticeUniversité ou école supérieure
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Università Cattolica del Sacro Cuore pays non établi dans la noticeUniversité ou école supérieure
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University of Florence Department of Experimental and Clinical Biomedical Sciences pays non établi dans la noticeUniversité ou école supérieure
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Ospedale San Carlo pays non établi dans la noticeÉtablissement de santé
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University of Naples Federico II Department of Clinical Medicine and Surgery pays non établi dans la noticeUniversité ou école supérieure
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IRCCS Istituto Auxologico Italiano pays non établi dans la noticeÉtablissement de santé
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Endocrine Unit of University Hospital of Messina pays non établi dans la noticeUniversité ou école supérieure
Department of Clinical and Biological Sciences — University of Turin, University of Messina et Oncology Unit — University of Brescia, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.