Curative Resection of Adrenocortical Carcinoma: Rates and Patterns of Postoperative Recurrence

Neda Amini, Georgios Antonios Margonis, Yuhree Kim, Thuy B. Tran, Lauren M. Postlewait, Shishir K. Maithel, Tracy S. Wang, Douglas B. Evans, Ioannis Hatzaras, Rivfka Shenoy, John E. Phay, Kara Keplinger, Ryan C. Fields, Linda X. Jin, Sharon M. Weber, Ahmed Salem, Jason K. Sicklick, Shady Gad, Adam C. Yopp, John C. MansourQuan Yang Duh, Natalie Seiser, Carmen C. Solorzano, Colleen M. Kiernan, Konstantinos I. Votanopoulos, Edward A. Levine, George A. Poultsides, Timothy M. Pawlik

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background: Adrenocortical carcinoma (ACC) is a rare malignancy. The aim of this study was to determine the incidence and patterns of recurrence after curative-intent surgery for ACC. Methods: Patients who underwent curative-intent resection for ACC between 1993 and 2014 were identified from 13 academic institutions participating in the United States ACC study group. Patients with metastasis or an R2 margin were excluded. Patterns and rates of recurrence were determined and classified as locoregional and distant recurrence. Results: A total of 180 patients with a median age of 52 years (interquartile range 43–61) were identified. Most patients underwent open surgery (n = 111, 64.5 %) and had an R0 resection margin (n = 117, 75.0 %). At last follow-up, 116 patients (64.4 %) had experienced recurrence (locoregional only, n = 41, 36.3 %; distant only, n = 51, 45.1 %; locoregional and distant, n = 21, 18.6 %). Median time to recurrence was 18.8 months. Several factors were associated with locoregional recurrence, including left-sided ACC location (odds ratio [OR] 2.71, 95 % confidence interval [CI] 1.06–6.89) and T3/T4 disease (reference T1/T2, OR 3.04, 95 % CI 1.19–7.80) (both p < 0.05). Distant recurrence was associated with larger tumor size (OR 1.11, 95 % CI 1.01–1.24) and T3/T4 disease (reference T1/T2, OR 5.23, 95 % CI 1.70–16.10) (both p < 0.05). Patients with combined locoregional and distant recurrence had worse survival (3- and 5-year survival: 39.5, 19.7 %) versus patients with distant-only (3- and 5-year survival 55.1, 43.3 %) or locoregional-only recurrence (3- and 5-year survival 81.4, 64.1 %) (p = 0.01). Conclusions: Nearly two-thirds of patients experienced disease recurrence after resection of ACC. Although a subset of patients experienced recurrence with locoregional disease only, many patients experienced recurrence with distant disease as a component of recurrence and had a poor prognosis.

Original languageEnglish (US)
JournalAnnals of Surgical Oncology
DOIs
StateAccepted/In press - Aug 18 2015

Fingerprint

Adrenocortical Carcinoma
Recurrence
Odds Ratio
Confidence Intervals
Survival

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Amini, N., Margonis, G. A., Kim, Y., Tran, T. B., Postlewait, L. M., Maithel, S. K., ... Pawlik, T. M. (Accepted/In press). Curative Resection of Adrenocortical Carcinoma: Rates and Patterns of Postoperative Recurrence. Annals of Surgical Oncology. https://doi.org/10.1245/s10434-015-4810-y

Curative Resection of Adrenocortical Carcinoma : Rates and Patterns of Postoperative Recurrence. / Amini, Neda; Margonis, Georgios Antonios; Kim, Yuhree; Tran, Thuy B.; Postlewait, Lauren M.; Maithel, Shishir K.; Wang, Tracy S.; Evans, Douglas B.; Hatzaras, Ioannis; Shenoy, Rivfka; Phay, John E.; Keplinger, Kara; Fields, Ryan C.; Jin, Linda X.; Weber, Sharon M.; Salem, Ahmed; Sicklick, Jason K.; Gad, Shady; Yopp, Adam C.; Mansour, John C.; Duh, Quan Yang; Seiser, Natalie; Solorzano, Carmen C.; Kiernan, Colleen M.; Votanopoulos, Konstantinos I.; Levine, Edward A.; Poultsides, George A.; Pawlik, Timothy M.

In: Annals of Surgical Oncology, 18.08.2015.

Research output: Contribution to journalArticle

Amini, N, Margonis, GA, Kim, Y, Tran, TB, Postlewait, LM, Maithel, SK, Wang, TS, Evans, DB, Hatzaras, I, Shenoy, R, Phay, JE, Keplinger, K, Fields, RC, Jin, LX, Weber, SM, Salem, A, Sicklick, JK, Gad, S, Yopp, AC, Mansour, JC, Duh, QY, Seiser, N, Solorzano, CC, Kiernan, CM, Votanopoulos, KI, Levine, EA, Poultsides, GA & Pawlik, TM 2015, 'Curative Resection of Adrenocortical Carcinoma: Rates and Patterns of Postoperative Recurrence', Annals of Surgical Oncology. https://doi.org/10.1245/s10434-015-4810-y
Amini, Neda ; Margonis, Georgios Antonios ; Kim, Yuhree ; Tran, Thuy B. ; Postlewait, Lauren M. ; Maithel, Shishir K. ; Wang, Tracy S. ; Evans, Douglas B. ; Hatzaras, Ioannis ; Shenoy, Rivfka ; Phay, John E. ; Keplinger, Kara ; Fields, Ryan C. ; Jin, Linda X. ; Weber, Sharon M. ; Salem, Ahmed ; Sicklick, Jason K. ; Gad, Shady ; Yopp, Adam C. ; Mansour, John C. ; Duh, Quan Yang ; Seiser, Natalie ; Solorzano, Carmen C. ; Kiernan, Colleen M. ; Votanopoulos, Konstantinos I. ; Levine, Edward A. ; Poultsides, George A. ; Pawlik, Timothy M. / Curative Resection of Adrenocortical Carcinoma : Rates and Patterns of Postoperative Recurrence. In: Annals of Surgical Oncology. 2015.
@article{bf664ea643284f51a201859c25ca9bbb,
title = "Curative Resection of Adrenocortical Carcinoma: Rates and Patterns of Postoperative Recurrence",
abstract = "Background: Adrenocortical carcinoma (ACC) is a rare malignancy. The aim of this study was to determine the incidence and patterns of recurrence after curative-intent surgery for ACC. Methods: Patients who underwent curative-intent resection for ACC between 1993 and 2014 were identified from 13 academic institutions participating in the United States ACC study group. Patients with metastasis or an R2 margin were excluded. Patterns and rates of recurrence were determined and classified as locoregional and distant recurrence. Results: A total of 180 patients with a median age of 52 years (interquartile range 43–61) were identified. Most patients underwent open surgery (n = 111, 64.5 {\%}) and had an R0 resection margin (n = 117, 75.0 {\%}). At last follow-up, 116 patients (64.4 {\%}) had experienced recurrence (locoregional only, n = 41, 36.3 {\%}; distant only, n = 51, 45.1 {\%}; locoregional and distant, n = 21, 18.6 {\%}). Median time to recurrence was 18.8 months. Several factors were associated with locoregional recurrence, including left-sided ACC location (odds ratio [OR] 2.71, 95 {\%} confidence interval [CI] 1.06–6.89) and T3/T4 disease (reference T1/T2, OR 3.04, 95 {\%} CI 1.19–7.80) (both p < 0.05). Distant recurrence was associated with larger tumor size (OR 1.11, 95 {\%} CI 1.01–1.24) and T3/T4 disease (reference T1/T2, OR 5.23, 95 {\%} CI 1.70–16.10) (both p < 0.05). Patients with combined locoregional and distant recurrence had worse survival (3- and 5-year survival: 39.5, 19.7 {\%}) versus patients with distant-only (3- and 5-year survival 55.1, 43.3 {\%}) or locoregional-only recurrence (3- and 5-year survival 81.4, 64.1 {\%}) (p = 0.01). Conclusions: Nearly two-thirds of patients experienced disease recurrence after resection of ACC. Although a subset of patients experienced recurrence with locoregional disease only, many patients experienced recurrence with distant disease as a component of recurrence and had a poor prognosis.",
author = "Neda Amini and Margonis, {Georgios Antonios} and Yuhree Kim and Tran, {Thuy B.} and Postlewait, {Lauren M.} and Maithel, {Shishir K.} and Wang, {Tracy S.} and Evans, {Douglas B.} and Ioannis Hatzaras and Rivfka Shenoy and Phay, {John E.} and Kara Keplinger and Fields, {Ryan C.} and Jin, {Linda X.} and Weber, {Sharon M.} and Ahmed Salem and Sicklick, {Jason K.} and Shady Gad and Yopp, {Adam C.} and Mansour, {John C.} and Duh, {Quan Yang} and Natalie Seiser and Solorzano, {Carmen C.} and Kiernan, {Colleen M.} and Votanopoulos, {Konstantinos I.} and Levine, {Edward A.} and Poultsides, {George A.} and Pawlik, {Timothy M.}",
year = "2015",
month = "8",
day = "18",
doi = "10.1245/s10434-015-4810-y",
language = "English (US)",
journal = "Annals of Surgical Oncology",
issn = "1068-9265",
publisher = "Springer New York",

}

TY - JOUR

T1 - Curative Resection of Adrenocortical Carcinoma

T2 - Rates and Patterns of Postoperative Recurrence

AU - Amini, Neda

AU - Margonis, Georgios Antonios

AU - Kim, Yuhree

AU - Tran, Thuy B.

AU - Postlewait, Lauren M.

AU - Maithel, Shishir K.

AU - Wang, Tracy S.

AU - Evans, Douglas B.

AU - Hatzaras, Ioannis

AU - Shenoy, Rivfka

AU - Phay, John E.

AU - Keplinger, Kara

AU - Fields, Ryan C.

AU - Jin, Linda X.

AU - Weber, Sharon M.

AU - Salem, Ahmed

AU - Sicklick, Jason K.

AU - Gad, Shady

AU - Yopp, Adam C.

AU - Mansour, John C.

AU - Duh, Quan Yang

AU - Seiser, Natalie

AU - Solorzano, Carmen C.

AU - Kiernan, Colleen M.

AU - Votanopoulos, Konstantinos I.

AU - Levine, Edward A.

AU - Poultsides, George A.

AU - Pawlik, Timothy M.

PY - 2015/8/18

Y1 - 2015/8/18

N2 - Background: Adrenocortical carcinoma (ACC) is a rare malignancy. The aim of this study was to determine the incidence and patterns of recurrence after curative-intent surgery for ACC. Methods: Patients who underwent curative-intent resection for ACC between 1993 and 2014 were identified from 13 academic institutions participating in the United States ACC study group. Patients with metastasis or an R2 margin were excluded. Patterns and rates of recurrence were determined and classified as locoregional and distant recurrence. Results: A total of 180 patients with a median age of 52 years (interquartile range 43–61) were identified. Most patients underwent open surgery (n = 111, 64.5 %) and had an R0 resection margin (n = 117, 75.0 %). At last follow-up, 116 patients (64.4 %) had experienced recurrence (locoregional only, n = 41, 36.3 %; distant only, n = 51, 45.1 %; locoregional and distant, n = 21, 18.6 %). Median time to recurrence was 18.8 months. Several factors were associated with locoregional recurrence, including left-sided ACC location (odds ratio [OR] 2.71, 95 % confidence interval [CI] 1.06–6.89) and T3/T4 disease (reference T1/T2, OR 3.04, 95 % CI 1.19–7.80) (both p < 0.05). Distant recurrence was associated with larger tumor size (OR 1.11, 95 % CI 1.01–1.24) and T3/T4 disease (reference T1/T2, OR 5.23, 95 % CI 1.70–16.10) (both p < 0.05). Patients with combined locoregional and distant recurrence had worse survival (3- and 5-year survival: 39.5, 19.7 %) versus patients with distant-only (3- and 5-year survival 55.1, 43.3 %) or locoregional-only recurrence (3- and 5-year survival 81.4, 64.1 %) (p = 0.01). Conclusions: Nearly two-thirds of patients experienced disease recurrence after resection of ACC. Although a subset of patients experienced recurrence with locoregional disease only, many patients experienced recurrence with distant disease as a component of recurrence and had a poor prognosis.

AB - Background: Adrenocortical carcinoma (ACC) is a rare malignancy. The aim of this study was to determine the incidence and patterns of recurrence after curative-intent surgery for ACC. Methods: Patients who underwent curative-intent resection for ACC between 1993 and 2014 were identified from 13 academic institutions participating in the United States ACC study group. Patients with metastasis or an R2 margin were excluded. Patterns and rates of recurrence were determined and classified as locoregional and distant recurrence. Results: A total of 180 patients with a median age of 52 years (interquartile range 43–61) were identified. Most patients underwent open surgery (n = 111, 64.5 %) and had an R0 resection margin (n = 117, 75.0 %). At last follow-up, 116 patients (64.4 %) had experienced recurrence (locoregional only, n = 41, 36.3 %; distant only, n = 51, 45.1 %; locoregional and distant, n = 21, 18.6 %). Median time to recurrence was 18.8 months. Several factors were associated with locoregional recurrence, including left-sided ACC location (odds ratio [OR] 2.71, 95 % confidence interval [CI] 1.06–6.89) and T3/T4 disease (reference T1/T2, OR 3.04, 95 % CI 1.19–7.80) (both p < 0.05). Distant recurrence was associated with larger tumor size (OR 1.11, 95 % CI 1.01–1.24) and T3/T4 disease (reference T1/T2, OR 5.23, 95 % CI 1.70–16.10) (both p < 0.05). Patients with combined locoregional and distant recurrence had worse survival (3- and 5-year survival: 39.5, 19.7 %) versus patients with distant-only (3- and 5-year survival 55.1, 43.3 %) or locoregional-only recurrence (3- and 5-year survival 81.4, 64.1 %) (p = 0.01). Conclusions: Nearly two-thirds of patients experienced disease recurrence after resection of ACC. Although a subset of patients experienced recurrence with locoregional disease only, many patients experienced recurrence with distant disease as a component of recurrence and had a poor prognosis.

UR - http://www.scopus.com/inward/record.url?scp=84939431839&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84939431839&partnerID=8YFLogxK

U2 - 10.1245/s10434-015-4810-y

DO - 10.1245/s10434-015-4810-y

M3 - Article

C2 - 26282907

AN - SCOPUS:84952630840

JO - Annals of Surgical Oncology

JF - Annals of Surgical Oncology

SN - 1068-9265

ER -