ISSN: 1301-2193 E-ISSN: 1308-9846
  • Turkish Journal of
    Endocrinology and Metabolism
ORIGINAL ARTICLE

Factors Affecting Survival in Adrenocortical Cancers: Single-Center Experience
Adrenokortikal Kanserlerde Sağ Kalıma Etki Eden Faktörler: Tek Merkez Deneyimi
Received Date : 12 Mar 2020
Accepted Date : 23 May 2020
Available Online : 24 Jun 2020
Doi: 10.25179/tjem.2020-74861 - Makale Dili: EN
Turk J Endocrinol Metab. 2020;24:221-229
Bu makale, CC BY-NC-SA altında lisanslanmış açık erişim bir makaledir.
ABSTRACT
Objective: Adrenocortical cancer (ACC) is one of the rare endocrine system cancers that are aggressive. Despite surgical treatment, the mortality rate is quite high. This study aimed to examine prognostic factors affecting survival in patients with ACC, the role of dehydroepiandrosterone sulfate (DHEA-S), and the maximum standard uptake (SUVmax) values on predicting mortality through the single-center data. Material and Methods: A total of 21 patients who were diagnosed with adrenal cancer and followed from a single center were included in the study. Patients who survived follow-ups were included in the survived group (n=6), and those who died were included in the dead group (n=15). The demographic, anatomical, pathological, and clinical characteristics of the patients were analyzed. Positron emission tomography- computerized tomography imaging and SUVmax values of adrenal masses were compared. The effect of all these data on survival was examined. Results: The mortality rate among patients with ACC was 71%. According to the Kaplan-Meier survival analysis, the average life expectancy was 23.66±2.79 (95% CI=18.18-29.13) months. The mass size of the survived and dead groups was 9.2±3.82 cm and 10.84±4.74 cm, respectively. The production rate of adrenal hormone was higher in the dead group (p<0.01; 80%). Moreover, the DHEA-S level and SUVmax values were statistically significantly higher in the dead group (p<0.001; p<0.05, respectively). Although no metastases were observed in the survived group during follow-ups after the operation, distant metastases were observed in 8 people from the dead group (53%; p<0.05). Conclusion: The mortality rate was very high in ACC despite surgical and medical treatments. The higher DHEA-S and SUVmax values may indicate that the overall survival duration was low.
ÖZET
Amaç: Adrenokortikal kanser [adrenocortical cancer (ACC)], agresif seyreden nadir görülen endokrin sistem kanserlerindendir. Cerrahi tedaviye rağmen mortalitesi oldukça yüksektir. Bu çalışmada, ACC hastalarda sağ kalıma etki eden prognostik faktörleri dehidroepiandrosteron sülfat (DHEA-S) ve maksimum standart uptake (SUVmax) değerlerinin mortaliteyi ön görmedeki rolünü, tek merkez verileri üzerinden araştırmayı amaçladık. Gereç ve Yöntemler: Adrenal kanser tanısı almış tek merkezden takipli 21 hasta çalışmaya alındı. Takiplerde hayatta olanlar sağ olan grup (n=6), ölenler ölü olan grup (n=15) olarak kabul edildi. Hastaların demografik, anatomik, patolojik ve klinik özelliklerine bakıldı. Adrenal kitlelerin, pozitron emisyon tomografi görüntülemesi ile SUVmax değerleri karşılaştırıldı.Tüm bu verilerin sağkalım üzerine etkileri araştırıldı. Bulgular: ACC’li hastalarda mortalite oranı %71 olarak bulundu. Kaplan- Meier yaşam analizine göre ortalama yaşam süresi 23,66±2,79 (%95 GA=18,18-29,13) ay olarak bulundu. Sırasıyla, sağ olan ve ölü olan grubun kitle boyutu 9,2±3,82 cm ve 10,84±4,74 cm olarak bulundu. Adrenal hormon üretimi, ölü olan grupta daha yüksek oranda izlendi (p<0,01; %80). Ayrıca DHEA-S seviyesi ve SUVmax değeri ölü olan grupta istatistiksel olarak yüksek bulundu (sırasıyla p<0,001; p<0,05). Operasyon sonrası takiplerde sağ olan grupta hiç metastaz yokken, ölü olan grupta 8 kişide uzak metastaz saptandı (%53; p<0,05). Sonuç: ACC’de mortalite oranı, cerrahi ve medikal tedavilere rağmen oldukça yüksektir. DHEA-S seviyesinin ve SUVmax değerinin yüksek olması, genel sağkalım süresinin düşük olduğunu öngörebilir.
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