Outcomes after resection of cortisol-secreting adrenocortical carcinoma

Georgios Antonios Margonis, Yuhree Kim, Thuy B. Tran, Lauren M. Postlewait, Shishir K. Maithel, Tracy S. Wang, Jason A. Glenn, 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. Mansour, Quan Yang DuhNatalie Seiser, Carmen C. Solorzano, Colleen M. Kiernan, Konstantinos I. Votanopoulos, Edward A. Levine, George A. Poultsides, Timothy M. Pawlik

Research output: Contribution to journalArticle

20 Scopus citations

Abstract

Background: We sought to define the impact of cortisol-secreting status on outcomes after surgical resection of adrenocortical carcinoma (ACC). Methods: The U.S ACC group database was queried to identify patients who underwent ACC resection between 1993 and 2014. The short-term and long-term outcomes were assessed. Results: The incidence of all functional and cortisol-secreting tumors was 40.6% and 22.6%, respectively. On multivariable analysis, cortisol secretion remained associated with an increased risk of postoperative complications (odds ratio = 2.25, 95 % confidence interval = 1.04 to 4.88; P = .04). At a median follow-up of 17.6 months, 118 patients (50.4%) had developed a recurrence. On multivariable analysis, after adjusting for patient and disease-related factors cortisol secretion independently predicted shorter recurrence-free survival (Hazard ratio = 2.05, 95% confidence interval = 1.16 to 3.60; P = .01). Conclusions: Cortisol secretion was associated with an increased risk of postoperative morbidity. Recurrence remains high among patients with ACC after surgery; cortisol secretion was independently associated with a shorter recurrence-free survival. Tailoring postoperative surveillance of ACC patients based on their cortisol secreting status may be important.

Original languageEnglish (US)
JournalAmerican Journal of Surgery
DOIs
StateAccepted/In press - Jul 26 2015

Keywords

  • Adrenocortical
  • Carcinoma
  • Cortisol
  • Outcomes

ASJC Scopus subject areas

  • Surgery

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    Margonis, G. A., Kim, Y., Tran, T. B., Postlewait, L. M., Maithel, S. K., Wang, T. S., Glenn, J. A., Hatzaras, I., Shenoy, R., Phay, J. E., Keplinger, K., Fields, R. C., Jin, L. X., Weber, S. M., Salem, A., Sicklick, J. K., Gad, S., Yopp, A. C., Mansour, J. C., ... Pawlik, T. M. (Accepted/In press). Outcomes after resection of cortisol-secreting adrenocortical carcinoma. American Journal of Surgery. https://doi.org/10.1016/j.amjsurg.2015.09.020