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New Findings on Presentation and Outcome of Patients With Adrenocortical Cancer: Results From a National Cohort Study.
Puglisi, Soraya; Calabrese, Anna; Ferraù, Francesco; Violi, Maria Antonia; Laganà, Marta; Grisanti, Salvatore; Ceccato, Filippo; Scaroni, Carla; Di Dalmazi, Guido; Stigliano, Antonio; Altieri, Barbara; Canu, Letizia; Loli, Paola; Pivonello, Rosario; Arvat, Emanuela; Morelli, Valentina; Perotti, Paola; Basile, Vittoria; Berchialla, Paola; Urru, Sara; Fiori, Cristian; Porpiglia, Francesco; Berruti, Alfredo; Pia, Anna; Reimondo, Giuseppe; Cannavò, Salvatore; Terzolo, Massimo.
Afiliación
  • Puglisi S; Internal Medicine, Department of Clinical and Biological Sciences, S. Luigi Hospital, University of Turin, 10043 Turin, Italy.
  • Calabrese A; Internal Medicine, Department of Clinical and Biological Sciences, S. Luigi Hospital, University of Turin, 10043 Turin, Italy.
  • Ferraù F; Endocrine Unit of University Hospital of Messina, University of Messina, 98124 Messina, Italy.
  • Violi MA; Endocrine Unit of University Hospital of Messina, University of Messina, 98124 Messina, Italy.
  • Laganà M; Oncology Unit, University of Brescia, 25123 Brescia, Italy.
  • Grisanti S; Oncology Unit, University of Brescia, 25123 Brescia, Italy.
  • Ceccato F; Endocrinology Unit, Department of Medicine DIMED, University-Hospital of Padua, 35128 Padua, Italy.
  • Scaroni C; Endocrinology Unit, Department of Medicine DIMED, University-Hospital of Padua, 35128 Padua, Italy.
  • Di Dalmazi G; Division of Endocrinology and Diabetes Prevention and Care Unit, IRCCS, University Hospital of Bologna, 40138 Bologna, Italy.
  • Stigliano A; Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum-University of Bologna, 40126 Bologna, Italy.
  • Altieri B; Endocrinology, Department of Clinical and Molecular Medicine, Sant'Andrea University Hospital, Sapienza University of Rome, 00189 Rome, Italy.
  • Canu L; Division of Endocrinology and Metabolic Diseases, University-Hospital Gemelli, IRCCS, Catholic University of the Sacred Heart, 00168 Rome, Italy.
  • Loli P; Endocrinology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, 50134 Florence, Italy.
  • Pivonello R; Endocrinology, Clinica Polispecialistica San Carlo, 20037 Milan, Italy.
  • Arvat E; Endocrinology Unit, Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy.
  • Morelli V; Oncological Endocrinology Unit, Department of Medical Sciences, University of Turin, 10043 Turin, Italy.
  • Perotti P; Department of Endocrine and Metabolic Disease, Istituto Auxologico Italiano, IRCSS, 20145 Milan, Italy.
  • Basile V; Internal Medicine, Department of Clinical and Biological Sciences, S. Luigi Hospital, University of Turin, 10043 Turin, Italy.
  • Berchialla P; Internal Medicine, Department of Clinical and Biological Sciences, S. Luigi Hospital, University of Turin, 10043 Turin, Italy.
  • Urru S; Statistical Unit, Department of Clinical and Biological Sciences, University of Turin, 10043 Turin, Italy.
  • Fiori C; Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35121 Padua, Italy.
  • Porpiglia F; Urology, Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, 10043 Turin, Italy.
  • Berruti A; Urology, Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, 10043 Turin, Italy.
  • Pia A; Oncology Unit, University of Brescia, 25123 Brescia, Italy.
  • Reimondo G; Internal Medicine, Department of Clinical and Biological Sciences, S. Luigi Hospital, University of Turin, 10043 Turin, Italy.
  • Cannavò S; Internal Medicine, Department of Clinical and Biological Sciences, S. Luigi Hospital, University of Turin, 10043 Turin, Italy.
  • Terzolo M; Endocrine Unit of University Hospital of Messina, University of Messina, 98124 Messina, Italy.
J Clin Endocrinol Metab ; 108(10): 2517-2525, 2023 09 18.
Article en En | MEDLINE | ID: mdl-37022947
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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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Corteza Suprarrenal / Neoplasias de las Glándulas Suprarrenales / Carcinoma Corticosuprarrenal Tipo de estudio: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male Idioma: En Revista: J Clin Endocrinol Metab Año: 2023 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Estados Unidos
Texto completo
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XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Corteza Suprarrenal / Neoplasias de las Glándulas Suprarrenales / Carcinoma Corticosuprarrenal Tipo de estudio: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male Idioma: En Revista: J Clin Endocrinol Metab Año: 2023 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Estados Unidos