Pd23-07 Prognostic Significance of Lymph Node Count in Surgically Treated Patients With T ₂₋₄ Stage Non-Metastatic Adrenocortical Carcinoma

You have accessJournal of UrologyAdrenal (PD23)1 May 2024PD23-07 PROGNOSTIC SIGNIFICANCE OF LYMPH NODE COUNT IN SURGICALLY TREATED PATIENTS WITH T2-4 STAGE NON-METASTATIC ADRENOCORTICAL CARCINOMA Anis Assad, Cristina Cano Garcia, Francesco Barletta, Reha B. Incesu, Simone Morra Morra, Lukas Scheipner, Andrea Baudo, Zhe Tian, Fred Saad, and Pierre I. Karakiewicz Anis AssadAnis Assad , Cristina Cano GarciaCristina Cano Garcia , Francesco BarlettaFrancesco Barletta , Reha B. IncesuReha B. Incesu , Simone Morra MorraSimone Morra Morra , Lukas ScheipnerLukas Scheipner , Andrea BaudoAndrea Baudo , Zhe TianZhe Tian , Fred SaadFred Saad , and Pierre I. KarakiewiczPierre I. Karakiewicz View All Author Informationhttps://doi.org/10.1097/01.JU.0001008664.51020.58.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The role of lymphadenectomy and the optimal lymph node count (LNC) cut-off in non-metastatic adrenocortical carcinoma (nmACC) are unclear. METHODS: Within the Surveillance, Epidemiology, and End Results (SEER) database, surgically treated nmACC patients with T2-4 stages were identified between 2004-2020. We tested for cancer-specific mortality (CSM) differences according to pathological N-stage (pN0 vs. pN1) and two previously recommended LNC cut-offs (≥4 vs.≥5) were tested in pN0 and subsequently in pN1 subgroups in Kaplan-Meier plots and multivariable Cox regression models. RESULTS: Of 710 surgically treated nmACC patients, 185 (26%) underwent lymphadenectomy and were assessable for further analyses based on available LNC data. Of 185 assessable patients, 152 (82%) were pN0 and 33 (18%) were pN1. In Kaplan-Meier analyses, CSM-free survival was 74 vs. 14 months (Δ 60 months, p≤0.001) in pN0 vs pN1 patients, respectively. In multivariable analyses, pN1 was an independent predictor of higher CSM (HR:3.13, p<0.001). In sensitivity analyses addressing pN0, LNC cut-off of≥4 was associated with lower CSM (multivariable hazard ratio [HR]: 0.52; p=, 0.002). In sensitivity analyses addressing pN0, no difference was recorded when a LNC cut-off of≥5 was used (HR:0.60, p=0.09). In pN1 patients, neither of the cut-offs (≥4 and≥5) resulted in a statistically significant stratification of CSM rate, and neither reached independent predictor status (all p>0.05). CONCLUSIONS: Lymphadenectomy provides a prognostic benefit in nmACC patients and identifies pN1 patients with dismal prognosis. Conversely, in pN0 patients, a LNC cut-off ≥4 identifies those with particularly favorable prognosis. Download PPTDownload PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e526 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Anis Assad More articles by this author Cristina Cano Garcia More articles by this author Francesco Barletta More articles by this author Reha B. Incesu More articles by this author Simone Morra Morra More articles by this author Lukas Scheipner More articles by this author Andrea Baudo More articles by this author Zhe Tian More articles by this author Fred Saad More articles by this author Pierre I. Karakiewicz More articles by this author Expand All Advertisement PDF downloadLoading ...