Adrenocortical Cancer in the Real World: A Comprehensive Analysis of Clinical Features and Management from the Turkish Oncology Group (TOG)

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dc.authoridKEFELI, UMUT/0000-0001-6126-5377
dc.authoridYaşar, Hatime Arzu/0000-0002-0545-1383
dc.authoridUcar, Gokhan/0000-0002-7649-1075
dc.authorwosidKEFELI, UMUT/V-6023-2017
dc.authorwosidYaşar, Hatime Arzu/HGC-5631-2022
dc.authorwosidUcar, Gokhan/AAA-8198-2021
dc.contributor.authorYasar, Hatime Arzu
dc.contributor.authorAktas, Burak Yasin
dc.contributor.authorUcar, Gokhan
dc.contributor.authorGoksu, Sema Sezgin
dc.contributor.authorBilgetekin, Irem
dc.contributor.authorCakar, Burcu
dc.contributor.authorSakin, Abdullah
dc.date.accessioned2024-06-12T10:50:46Z
dc.date.available2024-06-12T10:50:46Z
dc.date.issued2024
dc.departmentTrakya Üniversitesien_US
dc.description.abstractAdrenocortical cancer is a rare and poor prognostic malignant tumor. The definitions of prognostic factors in localized and metastatic diseases are important. In this paper, we defined the clinical features, management, and prognostic factors related to survival in patients with metastatic and nonmetastatic ACC. Cox regression analysis showed that age, Ki67 value, ECOG PS, and hormonal activity were significantly associated with survival in patients with nonmetastatic disease. Only patients who underwent surgery had significantly better OS compared with patients without surgery in univariate analyses of metastatic disease. Introduction: Adrenocortical carcinoma (ACC) is a rare yet highly malignant tumor associated with significant morbidity and mortality. This study aims to delineate the clinical features, survival patterns, and treatment modalities of ACC, providing insights into the disease's prognosis. Materials and Methods: A retrospective analysis of 157 ACC patients was performed to assess treatment methodologies, demographic patterns, pathological and clinical attributes, and laboratory results. The data were extracted from the hospital's database. Survival analyses were conducted using the Kaplan-Meier method, with univariate and multivariate analyses being performed through the log -rank test and Cox regression analyses. Results: The median age was 45, and 89.4% had symptoms at the time of diagnosis. The median tumor size was 12 cm. A total of 117 (79.6%) patients underwent surgery. A positive surgical border was detected in 26 (24.1%) patients. Adjuvant therapy was administered to 44.4% of patients. The median overall survival for the entire cohort was 44.3 months. Median OS was found to be 87.3 months (95% confidence interval [CI] 74.4-100.2) in stage 2, 25.8 (95% CI 6.5-45.1) months in stage 3, and 13.3 (95% CI 7.0-19.6) months in stage 4 disease. Cox regression analysis identified age, Ki67 value, Eastern Cooperative Oncology Group performance status, and hormonal activity as significant factors associated with survival in patients with nonmetastatic disease. In metastatic disease, only patients who underwent surgery exhibited significantly improved overall survival in univariate analyses. Conclusion: ACC is an uncommon tumor with a generally poor prognosis. Understanding the defining prognostic factors in both localized and metastatic diseases is vital. This study underscores age, Ki67 value, Eastern Cooperative Oncology Group performance status, and hormonal activity as key prognostic determinants for localized disease, offer ing cr itical insights into the complexities of ACC management and potential avenues for targeted therapeutic interventions.en_US
dc.identifier.doi10.1016/j.clgc.2024.102077
dc.identifier.issn1558-7673
dc.identifier.issn1938-0682
dc.identifier.issue3en_US
dc.identifier.pmid38626660en_US
dc.identifier.scopus2-s2.0-85190252782en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.urihttps://doi.org/10.1016/j.clgc.2024.102077
dc.identifier.urihttps://hdl.handle.net/20.500.14551/18109
dc.identifier.volume22en_US
dc.identifier.wosWOS:001233240400001en_US
dc.identifier.wosqualityN/Aen_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherCig Media Group, Lpen_US
dc.relation.ispartofClinical Genitourinary Canceren_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectAdjuvant Therapyen_US
dc.subjectAdrenocortical Carcinomaen_US
dc.subjectMitotaneen_US
dc.subjectNeutrophil-Lymphocyte Ratioen_US
dc.subjectPrognostic Factorsen_US
dc.subjectLaparoscopic Adrenalectomyen_US
dc.subjectPrognostic Roleen_US
dc.subjectPractice Guidelinesen_US
dc.subjectAdjuvant Mitotaneen_US
dc.subjectEuropean Networken_US
dc.subjectLymphocyte Ratioen_US
dc.subjectCarcinomaen_US
dc.subjectNeutrophilen_US
dc.subjectOutcomesen_US
dc.subjectTherapyen_US
dc.titleAdrenocortical Cancer in the Real World: A Comprehensive Analysis of Clinical Features and Management from the Turkish Oncology Group (TOG)en_US
dc.typeArticleen_US

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