Key result
Age <4 years (P<.00001), complete surgical resection (P<.00001), and Stage I disease (P<.00001) were significant predictors of better outcomes in pediatric adrenocortical tumors.
Why the study?
Pediatric adrenocortical tumors are rare and aggressive malignancies, but there is no consensus on outcome predictors in children.
Do specific clinical and tumor characteristics predict outcomes in children with adrenocortical tumors?
Meta-Analysis (n=1,006)
Do specific clinical and tumor characteristics predict outcomes in children with adrenocortical tumors?
p-value: p=<.00001
In pediatric adrenocortical tumors, younger age, complete resection, smaller tumor size, and early stage predict better outcomes, while Cushing syndrome predicts worse outcomes.
Supports risk stratification in pediatric ACT but should not yet change practice; leaves open need for prospective validation.
Pediatric adrenocortical tumors (ACT) are rare and sometimes aggressive malignancies, but there is no consensus on the outcome predictors in children. A systematic search of MEDLINE, SCOPUS, Web of Science, and the Cochrane Library for studies from 1994 to 2020 about pediatric ACT was performed. In 42 studies, 1006 patients, aged 0-18 years, were included. The meta-analyses resulted in the following predictors of better outcome: age <4 years (P < .00001), nonsecreting tumors (P = .004), complete surgical resection (P < .00001), tumor volume (P < .0001), tumor weight (P < .00001), tumor maximum diameter (P = .0009), and Stage I disease (P < .00001). Moreover, patients affected by Cushing syndrome showed a worse outcome (P < .0001). International prospective studies should be implemented to standardize clinical prognostic factors evaluation, together with pathological scores, in the stratification of pediatric ACT.
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Zambaiti et al. (2020) conducted a meta-analysis in Pediatric adrenocortical tumors (n=1,006). Clinical prognostic factors was evaluated on Better outcome (p=<.00001). Age <4 years (P<.00001), complete surgical resection (P<.00001), and Stage I disease (P<.00001) were significant predictors of better outcomes in pediatric adrenocortical tumors.
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