Abstract：
BACKGROUND:While roughly half of adrenocortical carcinomas are functional, whether functional status impacts outcomes remains controversial. We compared presentation and survival for functional and nonfunctional neoplasms. METHODS:Adult patients presented with adrenocortical carcinomas at the Mayo Clinic were included. Tumor characteristics and outcomes were analyzed. RESULTS:The 266 identified patients presented with stage I (6%), II (33%), III (26%), and IV disease (32%); stage was unknown in 3%. Fifty-three percent of tumors were functional; patients with functional adrenocortical carcinomas were younger, more likely to be female, and more likely to present with metastatic disease. Surgical resection was undertaken in 84% of patients with 69% having R0 resection. While 30-day morbidity was similar between functional and nonfunctional adrenocortical carcinomas, median overall survival was better for nonfunctional adrenocortical carcinomas (median 66 vs 22 months, P = .01). Functional adrenocortical carcinomas was independently associated with shorter survival after adjusting for age, sex, grade, stage, and resection attempt: hazard ratio = 1.5 (95% confidence interval, 1.04-2.14, P = .03). CONCLUSION:In our cohort, long term survival was worse for all patients with functional tumors. However, when analyzing patients with R0 resection, there was no survival difference between functional and nonfunctional adrenocortical carcinomas, signaling need for better understanding of adrenocortical carcinomas behavior to individualize and optimize treatment strategies.
journal_name
Surgeryjournal_title
Surgeryauthors
Sada A,Asaad M,Bews KA,Thompson GB,Young WF Jr,Bancos I,Farley DR,Dy BM,Lyden ML,Habermann EB,McKenzie TJdoi
10.1016/j.surg.2019.04.066subject
Has Abstractpub_date
2020-01-01 00:00:00pages
216-223issue
1eissn
0039-6060issn
1532-7361pii
S0039-6060(19)30547-1journal_volume
167pub_type
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