Tella SH, et al. - Researchers described the prognosticators of survival and overall survival (OS) outcomes in adrenocortical carcinoma (ACC) patients. They noted that OS was modified by increasing age, higher comorbidity index, grade, and stage of ACC at presentation. Surgical resection of the primary tumor results in improved survival, regardless of disease stage. Only in stage IV disease was postsurgical chemotherapy or radiation was noted to be of benefit.

Methods

• Researchers performed a retrospective analysis of data on 3,185 patients with pathologically confirmed ACC from the National Cancer Database (NCDB) from 2004 to 2015.
• The patients were evaluated for baseline description, survival outcomes, and predictors of survival.

Results

• At ACC diagnosis, median age was 55 (range: 18 to 90) years; no significant differences were evident regarding sex or stage of the disease at diagnosis.
• Multivariate analysis revealed poor prognosis in relation to increasing age, higher Charlson-Deyo comorbidity index score, high tumor grade, no surgical therapy (all P < 0.0001), stage IV disease (P=0.002), and lymphadenectomy during surgery (P=0.02).
• Significantly better median OS was evident for patients with stage I-III disease who were treated with surgical resection (63 vs 8 months; P < 0.001).
• In patients with stage IV disease, better median OS was observed in relation to treatment with surgery (19 vs 6 months; P < 0.001), and postsurgical radiation (29 vs 10 months; P < 0.001) or chemotherapy (22 vs 13 months; P=0.004).