Pd23-09 the Effect of Adrenalectomy on Overall Survival in Metastatic Adrenocortical Carcinoma

You have accessJournal of UrologyAdrenal (PD23)1 May 2024PD23-09 THE EFFECT OF ADRENALECTOMY ON OVERALL SURVIVAL IN METASTATIC ADRENOCORTICAL CARCINOMA Anis Assad, Reha B. Incesu, Simone Morra Morra, Lukas Scheipner, Andrea Baudo, Carolin Siech, Mario De Angelis, Letizia Jannello, Zhe Tian, Fred Saad, and Pierre I. Karakiewicz Anis AssadAnis Assad , Reha B. IncesuReha B. Incesu , Simone Morra MorraSimone Morra Morra , Lukas ScheipnerLukas Scheipner , Andrea BaudoAndrea Baudo , Carolin SiechCarolin Siech , Mario De AngelisMario De Angelis , Letizia JannelloLetizia Jannello , Zhe TianZhe Tian , Fred SaadFred Saad , and Pierre I. KarakiewiczPierre I. Karakiewicz View All Author Informationhttps://doi.org/10.1097/01.JU.0001008664.51020.58.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The magnitude of the survival benefit of adrenalectomy in metastatic adrenocortical carcinoma (mACC) is unknown. We addressed this knowledge gap. METHODS: mACC patients were identified within the Surveillance, Epidemiology, and End Results database (SEER 2004-2020) and we tested for differences according to adrenalectomy status. Kaplan-Meier plots, multivariable Cox regression models and landmark analyses were used. Sensitivity analyses focused on use of systemic therapy, contemporary (2012-2020) vs. historical (2004-2011), single vs. multiple metastatic sites and assessable specific solitary metastatic sites (lung only and liver only). RESULTS: Of 543 mACC patients, 194 (36%) underwent adrenalectomy. In multivariable analyses, adrenalectomy was associated with lower overall mortality without (hazard ratio [HR]: 0.39; p<0.001), as well as with three months' landmark analyses (HR: 0.57, p=0.002). The same association effect with three months' landmark analyses was recorded in systemic therapy exposed patients (HR: 0.49, p<0.001), contemporary patients (HR: 0.57, p=0.004), historical patients (HR: 0.42 , p<0.001), and in those with lung only solitary metastasis (HR: 0.50, p=0.02). Conversely, no significant association was recorded in systemic therapy naïve patients (HR: 0.68, p=0.3), those with multiple metastatic sites (HR: 0.55, p=0.07) and those with liver only solitary metastasis (HR: 0.98, p=0.9). CONCLUSIONS: The current results indicate a potential protective effect from adrenalectomy in mACC that applies to both historical and contemporary patients. This effect is pronounced in systemic therapy exposed and lung only metastasis patients. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e527 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Anis Assad 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 Carolin Siech More articles by this author Mario De Angelis More articles by this author Letizia Jannello 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 ...