@article{4de629a395c74223a4e1d1e2732294b8,
title = "The prognostic significance of adrenocortical carcinomas identified incidentally",
abstract = "Background and Objectives: Little is known regarding the difference in prognosis among patients who have an incidentally discovered adrenocortical carcinoma (ACC) vs those who present with signs or symptoms. We aimed to explore differences in the outcomes of these two populations. Methods: Data were collected on patients who underwent resection of ACC at 1 of 13 institutions between January 1993 and December 2014. Presentations were categorized as incidental vs symptomatic and outcomes were compared. Results: Among 227 patients, 100 were diagnosed incidentally while 127 patients presented with symptoms/signs. Clinical and pathological features were comparable among incidental vs nonincidental patients with ACC following the exceptions. Patients with incidentalomas were more likely to have a T1/T2 tumor (55.8% vs 34.8%; P < 0.01) and less likely to have a functional tumor (33.7% vs 47.9%; P = 0.04). Patients with an incidental ACC had improved median recurrence-free survival (RFS; 29.4 months) compared with patients with a nonincidental ACC (13.0 months; P = 0.03); however, on multivariable analysis, incidental ACC was not an independent predictor of survival. Conclusions: Patients with resected ACC identified incidentally had an improved RFS compared with the patients who presented with symptoms or signs. This difference may be related to the patients with incidental tumors having earlier T-stage disease.",
keywords = "carcinoma, functional, hormone, incidentaloma, symptomatic",
author = "{and the U.S. Adrenocortical Carcinoma Study Group} and Rossfeld, {Kara K.} and Maithel, {Shishir K.} and Jason Prescott and Wang, {Tracy S.} and Fields, {Ryan C.} and Weber, {Sharon M.} and Sicklick, {Jason K.} and Yopp, {Adam C} and Duh, {Quan Yang} and Solorzano, {Carmen C.} and Votanopoulos, {Konstantinos I.} and Ioannis Hatzaras and Poultsides, {George A.} and Shirley, {Lawrence A.}",
note = "Funding Information: The U.S. Adrenocortical Carcinoma Study Group comprises the listed authors as well as the following. John E. Phay, MD; Timothy M. Pawlik, MD, MPH, PhD: Division of Surgical Oncology, Department of Surgery, The Ohio State University, Columbus, Ohio Neil Saunders, MD; Lauren M. Postlewait, MD: Division of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, Georgia Jason Glenn, MD: Department of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin Linda X. Jin, MD: Department of Surgery, Washington University School of Medicine, St. Louis, Missouri Ahmed Salem, MD: Department of General Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin Shady Gad, MD: Department of Surgery, University of California San Diego, San Diego, California John C. Mansour, MD; Natalie Seiser, MD, PhD: Department of Surgery, University of California San Francisco, San Francisco, California Colleen M. Kiernan, MD, MPH: Division of Surgical Oncology, Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee Edward A. Levine, MD: Department of Surgery, Wake Forest School of Medicine, Winston-Salem, North Carolina Rivfka Shenoy, MD: Department of Surgery, New York University School of Medicine, New York, New York Thuy B. Tran, MD: Department of Surgery, Stanford University School of Medicine, Stanford, California Publisher Copyright: {\textcopyright} 2018 Wiley Periodicals, Inc.",
year = "2018",
month = dec,
day = "1",
doi = "10.1002/jso.25274",
language = "English (US)",
volume = "118",
pages = "1155--1162",
journal = "Journal of Surgical Oncology",
issn = "0022-4790",
publisher = "Wiley-Liss Inc.",
number = "7",
}