Actual 10-year survivors following resection of adrenocortical carcinoma
Thuy B. Tran MD
Department of Surgery, Stanford University School of Medicine, Stanford, California
Search for more papers by this authorLauren M. Postlewait MD
Department of Surgery, Emory University, Atlanta, Georgia
Search for more papers by this authorShishir K. Maithel MD
Department of Surgery, Emory University, Atlanta, Georgia
Search for more papers by this authorJason D. Prescott MD, PhD
Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
Search for more papers by this authorTracy S. Wang MD, MPH
Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin
Search for more papers by this authorJason Glenn MD
Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin
Search for more papers by this authorJohn E. Phay MD
Department of Surgery, Ohio State University, Columbus, Ohio
Search for more papers by this authorKara Keplinger MD
Department of Surgery, Ohio State University, Columbus, Ohio
Search for more papers by this authorRyan C. Fields MD
Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
Search for more papers by this authorLinda X. Jin MD
Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
Search for more papers by this authorSharon M. Weber MD
Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
Search for more papers by this authorAhmed Salem MD
Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
Search for more papers by this authorJason K. Sicklick MD
Department of Surgery, University of California San Diego, San Diego, California
Search for more papers by this authorShady Gad MD
Department of Surgery, University of California San Diego, San Diego, California
Search for more papers by this authorAdam C. Yopp MD
Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
Search for more papers by this authorJohn C. Mansour MD
Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
Search for more papers by this authorQuan-Yang Duh MD
Department of Surgery, University of California San Francisco, San Francisco, California
Search for more papers by this authorNatalie Seiser MD, PhD
Department of Surgery, University of California San Francisco, San Francisco, California
Search for more papers by this authorCarmen C. Solorzano MD
Department of Surgery, Vanderbilt University, Nashville, Tennessee
Search for more papers by this authorColleen M. Kiernan MD
Department of Surgery, Vanderbilt University, Nashville, Tennessee
Search for more papers by this authorKonstantinos I. Votanopoulos MD
Department of Surgery, Wake Forest Baptist Medical Center, Winston Salem, North Carolina
Search for more papers by this authorEdward A. Levine MD
Department of Surgery, Wake Forest Baptist Medical Center, Winston Salem, North Carolina
Search for more papers by this authorIoannis Hatzaras MD
Department of Surgery, New York University School of Medicine, New York, New York
Search for more papers by this authorRivfka Shenoy MD
Department of Surgery, New York University School of Medicine, New York, New York
Search for more papers by this authorTimothy M. Pawlik MD, MPH, PhD
Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
Department of Surgery, Ohio State University, Columbus, Ohio
Search for more papers by this authorJeffrey A. Norton MD
Department of Surgery, Stanford University School of Medicine, Stanford, California
Search for more papers by this authorCorresponding Author
George A. Poultsides MD
Department of Surgery, Stanford University School of Medicine, Stanford, California
Correspondence to: George A. Poultsides, MD, MS, FACS, Stanford University, 300 Pasteur Drive, Suite H3680D, Stanford, CA 94305. Fax: +1-650-736-1663. E-mail: [email protected]
Search for more papers by this authorThuy B. Tran MD
Department of Surgery, Stanford University School of Medicine, Stanford, California
Search for more papers by this authorLauren M. Postlewait MD
Department of Surgery, Emory University, Atlanta, Georgia
Search for more papers by this authorShishir K. Maithel MD
Department of Surgery, Emory University, Atlanta, Georgia
Search for more papers by this authorJason D. Prescott MD, PhD
Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
Search for more papers by this authorTracy S. Wang MD, MPH
Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin
Search for more papers by this authorJason Glenn MD
Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin
Search for more papers by this authorJohn E. Phay MD
Department of Surgery, Ohio State University, Columbus, Ohio
Search for more papers by this authorKara Keplinger MD
Department of Surgery, Ohio State University, Columbus, Ohio
Search for more papers by this authorRyan C. Fields MD
Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
Search for more papers by this authorLinda X. Jin MD
Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
Search for more papers by this authorSharon M. Weber MD
Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
Search for more papers by this authorAhmed Salem MD
Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
Search for more papers by this authorJason K. Sicklick MD
Department of Surgery, University of California San Diego, San Diego, California
Search for more papers by this authorShady Gad MD
Department of Surgery, University of California San Diego, San Diego, California
Search for more papers by this authorAdam C. Yopp MD
Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
Search for more papers by this authorJohn C. Mansour MD
Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
Search for more papers by this authorQuan-Yang Duh MD
Department of Surgery, University of California San Francisco, San Francisco, California
Search for more papers by this authorNatalie Seiser MD, PhD
Department of Surgery, University of California San Francisco, San Francisco, California
Search for more papers by this authorCarmen C. Solorzano MD
Department of Surgery, Vanderbilt University, Nashville, Tennessee
Search for more papers by this authorColleen M. Kiernan MD
Department of Surgery, Vanderbilt University, Nashville, Tennessee
Search for more papers by this authorKonstantinos I. Votanopoulos MD
Department of Surgery, Wake Forest Baptist Medical Center, Winston Salem, North Carolina
Search for more papers by this authorEdward A. Levine MD
Department of Surgery, Wake Forest Baptist Medical Center, Winston Salem, North Carolina
Search for more papers by this authorIoannis Hatzaras MD
Department of Surgery, New York University School of Medicine, New York, New York
Search for more papers by this authorRivfka Shenoy MD
Department of Surgery, New York University School of Medicine, New York, New York
Search for more papers by this authorTimothy M. Pawlik MD, MPH, PhD
Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
Department of Surgery, Ohio State University, Columbus, Ohio
Search for more papers by this authorJeffrey A. Norton MD
Department of Surgery, Stanford University School of Medicine, Stanford, California
Search for more papers by this authorCorresponding Author
George A. Poultsides MD
Department of Surgery, Stanford University School of Medicine, Stanford, California
Correspondence to: George A. Poultsides, MD, MS, FACS, Stanford University, 300 Pasteur Drive, Suite H3680D, Stanford, CA 94305. Fax: +1-650-736-1663. E-mail: [email protected]
Search for more papers by this authorAbstract
Background
Adrenocortical carcinoma (ACC) is a rare and aggressive malignancy with limited therapeutic options beyond surgical resection. The characteristics of actual long-term survivors following surgical resection for ACC have not been previously reported.
Method
Patients who underwent resection for ACC at one of 13 academic institutions participating in the US Adrenocortical Carcinoma Group from 1993 to 2014 were analyzed. Patients were stratified into four groups: early mortality (died within 2 years), late mortality (died within 2–5 years), actual 5-year survivor (survived at least 5 years), and actual 10-year survivor (survived at least 10 years). Patients with less than 5 years of follow-up were excluded.
Results
Among the 180 patients available for analysis, there were 49 actual 5-year survivors (27%) and 12 actual 10-year survivors (7%). Patients who experienced early mortality had higher rates of cortisol-secreting tumors, nodal metastasis, synchronous distant metastasis, and R1 or R2 resections (all P < 0.05). The need for multi-visceral resection, perioperative blood transfusion, and adjuvant therapy correlated with early mortality. However, nodal involvement, distant metastasis, and R1 resection did not preclude patients from becoming actual 10-year survivors. Ten of twelve actual 10-year survivors were women, and of the seven 10-year survivors who experienced disease recurrence, five had undergone repeat surgery to resect the recurrence.
Conclusion
Surgery for ACC can offer a 1 in 4 chance of actual 5-year survival and a 1 in 15 chance of actual 10-year survival. Long-term survival was often achieved with repeat resection for local or distant recurrence, further underscoring the important role of surgery in managing patients with ACC. J. Surg. Oncol. 2016;114:971–976. © 2016 Wiley Periodicals, Inc.
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