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Cited by 451Adrenal and Paraganglionic TumorsRenal cell carcinoma treatmentAdrenal Hormones and Disorders

Extent of disease at presentation and outcome for adrenocortical carcinoma: have we made progress?

Kebebew, Electron, Reiff, Emily, Duh, Quan‐Yang, Clark, Orlo H., McMillan, Alex·2006·World Journal of Surgery
DOI 10.1007/s00268-005-0329-x
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Abstract

BACKGROUND: Adrenocortical carcinoma (ACC), a rare and aggressive malignancy, accounts for up to 14% of adrenal incidentalomas. The only chance of cure for ACC is diagnosis at an early stage; therefore, a main indication for adrenalectomy in patients with adrenal incidentaloma has been the potential risk of ACC. Recent studies suggest that this has led to earlier stage of ACC at diagnosis, more curative operations, and better survival. METHODS: We analyzed data on ACC from The National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database. Four equal time quartiles (1973-1979, 1980-1986, 1987-1993, and 1994-2000) were compared for changes in demographics, pathology, treatment, and cause-specific mortality. RESULTS: The average age was 51.2 years (range: 1-97), and 45.9% of patients were men. The average tumor size was 12 cm (range: 2-36 cm), and only 4.2% were < or = 6 cm. Most (88%) patients had surgical resection of their tumor, and external beam radiotherapy was used in only 12% of patients. Between the time quartiles compared (as well as annually), there was no significant difference at presentation in age at diagnosis, sex, race/ethnicity, tumor size, tumor grade, the frequency of distant metastasis, and overall TNM stage. Low tumor grade, lower stage of ACC, later time quartile, and surgical resection were associated with a lower cause-specific mortality by univariate analysis (P < or = 0.002) and by multivariate analysis (P < or = 0.031). CONCLUSIONS: Although adrenal incidentalomas have become a common indication for adrenalectomy, this has not resulted in patients with ACC being diagnosed earlier or treated at a lower stage of disease at the national level. The most important predictors of survival in these patients are tumor grade, tumor stage, and surgical resection.

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  • SEER database estimates ACC incidence at approximately 0.72 per million cases per year, leading to 0.2% of all cancer deaths in the United States.

    “The Surveillance, Epidemiology, and End Results (SEER) database provides an estimation of incidence of approximately 0.72 per million cases per year leading to 0.2% of all cancer deaths in the United States (4).”

    From Adrenocortical carcinoma (2014) · cites this paper as [4]

  • In the United States, radiotherapy is used in approximately 10% of ACC cases.

    “In the United States, it is used in approximately 10% of cases, according to analyses of both the National Cancer Data Base and the SEER program (4, 11, 90).”

    From Adrenocortical carcinoma (2014) · cites this paper as [4]

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Authors
Kebebew, E., Reiff, E., Duh, Q., Clark, O. H., & McMillan, A.
Affiliations
University of California, San Francisco (US)
Corresponding author
Kebebew, Electron
ORCID
Venue
World Journal of Surgery
Publisher
Wiley
Published
2006-03-10
Volume
30
Issue
5
Pages
872-878
ISSN
  • 0364-2313 (ISSN-L)
  • 1432-2323
DOI
10.1007/s00268-005-0329-x
OpenAlex
W2096051245
Cited by
451
References
21
Citations by year
2026: 12 · 2025: 18 · 2024: 28 · 2023: 35 · 2022: 33 · 2021: 47 · 2020: 44 · 2019: 30 · 2018: 27 · 2017: 25 · 2016: 21 · 2015: 35 · 2014: 12 · 2013: 14 · 2012: 17
FWCI
10.17
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • World Journal of Surgery (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Renal cell carcinoma treatment
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
Keywords
adrenocortical carcinoma, adrenal incidentaloma, adrenalectomy, tumor size, tumor grade, TNM stage, distant metastasis, surgical resection, external beam radiotherapy, cause-specific mortality, survival predictors, temporal trends in diagnosis
MeSH terms
Adolescent, Adrenal Cortex Neoplasms, Adrenalectomy, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Female, Humans, Infant, Male, Middle Aged, Neoplasm Staging, Retrospective Studies, United States, Cohort Studies, Treatment Outcome, Adrenocortical Carcinoma, SEER Program, Radiotherapy, Adjuvant

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