Association of tumor size with metastatic potential and survival in patients with adrenocortical carcinoma: an analysis of the National Cancer Database

作者：Canter Daniel J; Mallin Katherine; Uzzo Robert G; Egleston Brian L; Simhan Jay; Walton John; Smaldone Marc C; Master Viraj A; Bratslaysky Gennady; Kutikov Alexander^*

来源：Canadian Journal of Urology, 2013, 20(5): 6915-6921.

• adrenocortical carcinoma
• adrenal mass
• National Cancer Database
• tumor size
• adrenalectomy

Introduction: To assess the impact of size at presentation in patients with adrenocortical carcinoma (ACC) on rates of synchronous metastatic disease and survival following resection using a large administrative dataset. %26lt;br%26gt;Materials and methods: We queried the National Cancer Database (NCDB) dataset to assemble a cohort of patients with ACC based on SEER staging (1985-2000). Patients were stratified into three groups based on surgical tumor size cutoffs: %26lt; 4 cm, 4 cm-6 cm, and %26gt; 6 cm. Rates of metastatic disease at presentation in all ACC patients as well as relative survival for patients after resection of localized lesions were calculated and compared among groups. %26lt;br%26gt;Results: A total of 2248 patients had available staging information for analysis. Tumor size at presentation did not relate to likelihood of non-localized disease at presentation (p = 0.09). A restricted cubic splines analysis revealed a clinically insignificant relationship between tumor size and advanced disease at presentation (OR = 1.02 for each centimeter change in tumor size, p = 0.004, 95% CI 1.01-1.03). On multivariate analysis, only patient age (p %26lt; 0.01), and not tumor size, was a significant predictor of overall survival among patients undergoing resection of localized ACCs. %26lt;br%26gt;Conclusions: Our data suggest that tumor size is imperfect in predicting presence of distant disease at presentation, nor does it consistently correlate with patient survival after resection of localized ACC.

• 出版日期2013-10