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July 29, 2010The Journal of Clinical Endocrinology & MetabolismOpen Access

Improved Survival in Patients with Stage II Adrenocortical Carcinoma Followed Up Prospectively by Specialized Centers

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Key result

Prospective follow-up early after surgery for stage II adrenocortical carcinoma was associated with higher 5-year survival compared to retrospective registration (96% vs. 55%, P<0.05).

Why the study?

Does early prospective follow-up by specialized centers improve survival and reduce recurrence in adult patients with stage II adrenocortical carcinoma compared to retrospective registration?

Population

149 adult patients with stage II adrenocortical carcinoma (ACC)

Comparison

Prospective follow-up early after surgery and… vs Registration with the German ACC registry later…

Design

Cohort

Follow-up

5 years

Authors

MFMartin FaßnachtSJSarah JohanssenWFWiebke Fenske

Discussion

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Overview

May support specialized follow-up in stage II ACC; challenges retrospective estimates via referral bias and leaves open need for RCTs.

Study Design

Type

Cohort (n=149)

Multicenter

Yes

Structured PICO

Does early prospective follow-up by specialized centers improve survival and reduce recurrence in adult patients with stage II adrenocortical carcinoma compared to retrospective registration?

P
Population
149 adult patients with stage II adrenocortical carcinoma, comparing prospective early follow-up at specialized centers versus retrospective registry enrollment to assess recurrence and 5-year survival.
E
Exposure
Prospective follow-up early after surgery and counseling by a specialized center (n=30)
C
Comparator
Registration with the German ACC registry later than 4 months after diagnosis (retrospective group, n=119)
O
Outcome
Recurrence rate and 5-year survivalhard clinical

Main Result

Absolute Event Rate: 96% vs 55%

p-value: p=<0.05

Early prospective follow-up by specialized centers and use of adjuvant mitotane significantly improve survival and reduce recurrence in stage II adrenocortical carcinoma, highlighting a major referral bias in previous retrospective series.

Cite This Study

Faßnacht et al. (2010) conducted a cohort in Stage II adrenocortical carcinoma (ACC) (n=149). Prospective follow-up early after surgery vs. Retrospective registration >4 months after diagnosis was evaluated on 5-year survival (p=<0.05). Prospective follow-up early after surgery for stage II adrenocortical carcinoma was associated with higher 5-year survival compared to retrospective registration (96% vs. 55%, P<0.05).

synapsesocial.com/papers/6a7ca807a42cae215d7cd0d1https://doi.org/10.1210/jc.2010-0803
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Limited prognostic value of the 2004 International Union Against Cancer staging classification for adrenocortical carcinoma2008 · 694 citations
  2. 2Clinical Features of Adrenocortical Carcinoma, Prognostic Factors, and the Effect of Mitotane Therapy1990 · 718 citations
  3. 3Adrenal cortical carcinoma2001 · 386 citations
  4. 4The long-term survival in adrenocortical carcinoma with active surgical management and use of monitored mitotane2009 · 75 citations
  5. 5Adrenocortical carcinomas: surgical trends and results of a 253‐patient series from the French Association of Endocrine Surgeons study group2001 · 543 citations