机构：[1]Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041 Sichuan, China四川大学华西医院[2]Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China四川大学华西医院
Adrenocortical carcinoma (ACC) is a rare cancer with poor survival. We sought to identify prognostic factors and assess its clinical utility in postoperative management of nonmetastatic ACC.
We included 65 patients who underwent adrenalectomy and clinicopathological diagnosed as European Network for the Study of Adrenal Tumors (ENSAT) stage I-III ACC in our center from 2009 to 2017. Potential clinicopathological parameters were selected. The prognostic correlation, including overall survival (OS) and recurrence-free survival (RFS), was analyzed using Kaplan-Meier method and univariate and multivariate Cox model.
The 2-year and 5-year post-surgery survival rate were 54.6% (95%CI: 42.5-70.1%) and 33.5% (95%CI: 22.3-50.6%), respectively. 46 (70.8%) cases were symptomatic ACC. Tumor-related or hormone-related symptom was identified as independent prognostic factor in OS (HR = 5.5, 95%CI: 1.87-16.16) and RFS (HR = 3.62, 95%CI: 1.28-10.24). Higher tumor grade (Weiss score > 6 or Ki67 index ≥ 20%) was independently associated with poor OS (HR = 4.73, 95%CI: 2.15-10.43). R status (R1/R2/Rx) was independently correlated with worse RFS (HR = 2.56, 95%CI:1.21-5.43). Accordingly, patients with higher GRAS (Grade, R status, age, and symptoms) score were more likely to have poor prognosis (OS: HR = 2.7, 95%CI: 1.43-5.11 and RFS: HR = 3.31, 95%CI: 1.68-6.52, respectively).
Symptoms, higher tumor grade and positive/unknown R status were independent risk factors in stage I-III ACC. Comprehensive consideration of GRAS parameters may optimize the prognostic assessment for postoperative patients.
基金：
This work was supported by the Science and Technology
Foundation of the Sichuan Province (2016FZ0099 to Xin Wei
and 2017SZ0123 to Zhihong Liu), and the 1.3.5 project for disciplines
of excellence, West China Hospital, Sichuan University.
语种：
外文
PubmedID：
中科院(CAS)分区：
出版当年[2020]版：
大类|2 区医学
小类|3 区内分泌学与代谢
最新[2023]版：
大类|3 区医学
小类|3 区内分泌学与代谢
第一作者：
第一作者机构：[1]Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu 610041 Sichuan, China
共同第一作者：
通讯作者：
推荐引用方式(GB/T 7714)：
Jiayu Liang,Zhihong Liu,Liang Zhou,et al.The clinical utility of 'GRAS' parameters in stage I-III adrenocortical carcinomas: long-term data from a high-volume institution.[J].Endocrine.2020,67(2):449-456.doi:10.1007/s12020-019-02141-2.
APA：
Jiayu Liang,Zhihong Liu,Liang Zhou,Yongquan Tang,Chuan Zhou...&Yuchun Zhu.(2020).The clinical utility of 'GRAS' parameters in stage I-III adrenocortical carcinomas: long-term data from a high-volume institution..Endocrine,67,(2)
MLA：
Jiayu Liang,et al."The clinical utility of 'GRAS' parameters in stage I-III adrenocortical carcinomas: long-term data from a high-volume institution.".Endocrine 67..2(2020):449-456
