Features of synchronous versus metachronous metastasectomy in adrenal cortical carcinoma: Analysis from the US adrenocortical carcinoma database

被引：11

作者：

Prendergast, Katherine M. ^{[1
]}

Smith, Paula Marincola ^{[2
]}

Tran, Thuy B. ^{[3
]}

Postlewait, Lauren M. ^{[4
]}

Maithel, Shishir K. ^{[4
]}

Prescott, Jason D. ^{[5
]}

Pawlik, Timothy M. ^{[5
]}

Wang, Tracy S. ^{[6
]}

Glenn, Jason ^{[6
]}

Hatzaras, Ioannis ^{[7
]}

Shenoy, Rivfka ^{[7
]}

Phay, John E. ^{[8
]}

Shirley, Lawrence A. ^{[8
]}

Fields, Ryan C. ^{[9
]}

Jin, Linda X. ^{[9
]}

Weber, Sharon M. ^{[10
]}

Salem, Ahmed ^{[10
]}

Sicklick, Jason K. ^{[11
]}

Gad, Shady ^{[11
]}

Yopp, Adam C. ^{[12
]}

Mansour, John C. ^{[12
]}

Quan-Yang Duh ^{[13
]}

Seiser, Natalie ^{[13
]}

Votanopoulos, Konstantinos, I ^{[14
]}

Levine, Edward A. ^{[14
]}

Poultsides, George A. ^{[3
]}

Solorzano, Carmen C. ^{[2
]}

Kiernan, Colleen M. ^{[2
]}

机构：

[1] Vanderbilt Univ, Sch Med, Nashville, TN 37232 USA

[2] Vanderbilt Univ, Dept Surg, Nashville, TN 37232 USA

[3] Stanford Univ, Dept Surg, Sch Med, Stanford, CA 94305 USA

[4] Emory Univ, Winship Canc Inst, Dept Surg, Div Surg Oncol, Atlanta, GA 30322 USA

[5] Johns Hopkins Univ, Sch Med, Dept Surg, Baltimore, MD 21205 USA

[6] Med Coll Wisconsin, Dept Surg, 8700 W Wisconsin Ave, Milwaukee, WI 53226 USA

[7] NYU, Dept Surg, Sch Med, New York, NY 10016 USA

[8] Ohio State Univ, Dept Surg, Columbus, OH 43210 USA

[9] Washington Univ, Sch Med, Dept Surg, St Louis, MO 63110 USA

[10] Univ Wisconsin, Dept Gen Surg, Sch Med & Publ Hlth, Madison, WI USA

[11] Univ Calif San Diego, Dept Surg, San Diego, CA 92103 USA

[12] Univ Texas Southwestern Med Ctr Dallas, Dept Surg, Dallas, TX USA

[13] Univ Calif San Francisco, Dept Surg, San Francisco, CA USA

[14] Wake Forest Sch Med, Dept Surg, Winston Salem, NC 27101 USA

来源：

SURGERY | 2020年 / 167卷 / 02期

关键词：

RESECTION; MANAGEMENT; RECURRENT; SURVIVAL; OUTCOMES; CANCER;

D O I：

10.1016/j.surg.2019.05.024

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Background: Adrenocortical carcinoma is a rare, aggressive cancer. We compared features of patients who underwent synchronous versus metachronous metastasectomy. Methods: Adult patients who underwent resection for metastatic adrenocortical carcinoma from 1993 to 2014 at 13 institutions of the US adrenocortical carcinoma group were analyzed retrospectively. Patients were categorized as synchronous if they underwent metastasectomy at the index adrenalectomy or metachronous if they underwent resection after recurrence of the disease. Factors associated with overall survival were assessed by univariate analysis. Results: In the study, 84 patients with adrenocortical carcinoma underwent metastasectomy; 26 (31%) were synchronous and 58 (69%) were metachronous. Demographics were similar between groups. The synchronous group had more T4 tumors at the index resection (42 vs 3%, P < .001). The metachronous group had prolonged median survival after the index resection (86.3 vs 17.3 months, P < .001) and metastasectomy (36.9 vs 17.3 months, P = .007). Synchronous patients with RO resections had improved survival compared to patients with R1/2 resections (P = .008). Margin status at metachronous metastasectomy was not associated with survival (P = .452). Conclusion: Select patients with metastatic adrenocortical carcinoma may benefit from metastasectomy. Patients with metachronous metastasectomy have a more durable survival benefit than those undergoing synchronous metastasectomy. This study highlights need for future studies examining differences in tumor biology that could explain outcome disparities in these distinct patient populations. (C) 2019 Elsevier Inc. All rights reserved.

引用

页码：352 / 357

页数：6

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