Journal Basic Info
- Impact Factor: 1.995**
- H-Index: 8
- ISSN: 2474-1647
- DOI: 10.25107/2474-1647
Major Scope
- Thoracic Surgery
- General Surgery
- Endocrine Surgery
- Robotic Surgery
- Neurological Surgery
- Obstetrics Surgery
- Oral and Maxillofacial Surgery
- Colon and Rectal Surgery
Abstract
Citation: Clin Surg. 2016;1(1):1017.Research Article | Open Access
Adrenocortical Carcinoma in Adults and Children: A Population-Based Outcomes Study involving 1,623 Patients from the Surveillance, Epidemiology, and End Result (SEER) Database (1973-2012)
Mahendraraj K, Lau CSM, Sidhu K and Chamberlain RS
Department of Surgery, Saint Barnabas Medical Center, NJ, USA
Saint George’s University School of Medicine, West Indies
Department of Surgery, New Jersey Medical School, Rutgers University, NJ, USA
*Correspondance to: Ronald S. Chamberlain
PDF Full Text DOI: 10.25107/2474-1647.1017
Abstract
Background: Adrenocortical carcinoma (ACC), a rare endocrine tumor, is typically aggressive in adult patients, while ACC inpediatric patients follows an unpredictable course which is poorly studied. This study examines a large cohort of adult and pediatric ACC patients in an effort to identify demographic, pathologic, and clinical factors which affect clinical outcomes.Methods: Data on 1,623 patients (101 pediatric patients <20 years and 1,522 adult patients ≥20 years) were abstracted from the Surveillance, Epidemiology, and End Result (SEER) database (1973- 2012). Standard statistical analyses were performed.Results: ACC most commonly occurred in Caucasian females with tumors>4 cm in size. More pediatric patients age <5 were Hispanic compared to adults. Pediatric patients age <5 had significantly less metastatic disease compared to patients age 5-9, age 10-19 and age ≥20. Surgical resection was the most common treatment modality and significantly improved overall survival (OS) in all patients. Pediatric patients age<5 had the highest OS and lowest mortality whereas, pediatric patients age 10-19 had the highest mortality and the lowest 1-, 2- and 5-year survival. Multivariate analysis identified age>10 (OR 46.6), distant disease (OR 13.7) and undifferentiated grade (OR 6.0) as independently associated with increased mortality, p<0.05.Conclusions: ACC is an aggressive tumor affecting adults and children with a bimodal distribution. Surgical resection significantly improves OS in all groups, particularly pediatric patients age <5. Advancing age represents a key factor in the prognosis of ACC and should be considered in addition to tumor grade and stage, when risk stratifying patients.
Keywords
Adrenocortical carcinoma; Adrenal cortex tumors; Pediatric cancer; SEER
Cite the article
Mahendraraj K, Lau CSM, Sidhu K, Chamberlain RS. Adrenocortical Carcinoma in Adults and Children: A Population-Based Outcomes Study involving 1,623 Patients from the Surveillance, Epidemiology, and End Result (SEER) Database (1973-2012). Clin Surg. 2016; 1: 1017.