Outcomes after resection of cortisol-secreting adrenocortical carcinoma

Georgios Antonios Margonis; Yuhree Kim; Thuy B. Tran; Lauren M. Postlewait; Shishir K. Maithel; Tracy S. Wang; Jason A. Glenn; Ioannis Hatzaras; Rivfka Shenoy; John E. Phay; Kara Keplinger; Ryan C. Fields; Linda X. Jin; Sharon M. Weber; Ahmed Salem; Jason K. Sicklick; Shady Gad; Adam C. Yopp; John C. Mansour; Quan Yang Duh; Natalie Seiser; Carmen C. Solorzano; Colleen M. Kiernan; Konstantinos I. Votanopoulos; Edward A. Levine; George A. Poultsides; Timothy M. Pawlik

doi:10.1016/j.amjsurg.2015.09.020

Outcomes after resection of cortisol-secreting adrenocortical carcinoma

Georgios Antonios Margonis, Yuhree Kim, Thuy B. Tran, Lauren M. Postlewait, Shishir K. Maithel, Tracy S. Wang, Jason A. Glenn, Ioannis Hatzaras, Rivfka Shenoy, John E. Phay, Kara Keplinger, Ryan C. Fields, Linda X. Jin, Sharon M. Weber, Ahmed Salem, Jason K. Sicklick, Shady Gad, Adam C. Yopp, John C. Mansour, Quan Yang DuhNatalie Seiser, Carmen C. Solorzano, Colleen M. Kiernan, Konstantinos I. Votanopoulos, Edward A. Levine, George A. Poultsides, Timothy M. Pawlik

School of Medicine

Research output: Contribution to journal › Article › peer-review

25 Scopus citations

Abstract

Background: We sought to define the impact of cortisol-secreting status on outcomes after surgical resection of adrenocortical carcinoma (ACC). Methods: The U.S ACC group database was queried to identify patients who underwent ACC resection between 1993 and 2014. The short-term and long-term outcomes were assessed. Results: The incidence of all functional and cortisol-secreting tumors was 40.6% and 22.6%, respectively. On multivariable analysis, cortisol secretion remained associated with an increased risk of postoperative complications (odds ratio = 2.25, 95 % confidence interval = 1.04 to 4.88; P = .04). At a median follow-up of 17.6 months, 118 patients (50.4%) had developed a recurrence. On multivariable analysis, after adjusting for patient and disease-related factors cortisol secretion independently predicted shorter recurrence-free survival (Hazard ratio = 2.05, 95% confidence interval = 1.16 to 3.60; P = .01). Conclusions: Cortisol secretion was associated with an increased risk of postoperative morbidity. Recurrence remains high among patients with ACC after surgery; cortisol secretion was independently associated with a shorter recurrence-free survival. Tailoring postoperative surveillance of ACC patients based on their cortisol secreting status may be important.

Original language	English (US)
Journal	American Journal of Surgery
DOIs	https://doi.org/10.1016/j.amjsurg.2015.09.020
State	Accepted/In press - Jul 26 2015

Keywords

Adrenocortical
Carcinoma
Cortisol
Outcomes

ASJC Scopus subject areas

Surgery

Access to Document

10.1016/j.amjsurg.2015.09.020

Cite this

Margonis, G. A., Kim, Y., Tran, T. B., Postlewait, L. M., Maithel, S. K., Wang, T. S., Glenn, J. A., Hatzaras, I., Shenoy, R., Phay, J. E., Keplinger, K., Fields, R. C., Jin, L. X., Weber, S. M., Salem, A., Sicklick, J. K., Gad, S., Yopp, A. C., Mansour, J. C., ... Pawlik, T. M. (Accepted/In press). Outcomes after resection of cortisol-secreting adrenocortical carcinoma. American Journal of Surgery. https://doi.org/10.1016/j.amjsurg.2015.09.020

Margonis, GA, Kim, Y, Tran, TB, Postlewait, LM, Maithel, SK, Wang, TS, Glenn, JA, Hatzaras, I, Shenoy, R, Phay, JE, Keplinger, K, Fields, RC, Jin, LX, Weber, SM, Salem, A, Sicklick, JK, Gad, S, Yopp, AC, Mansour, JC, Duh, QY, Seiser, N, Solorzano, CC, Kiernan, CM, Votanopoulos, KI, Levine, EA, Poultsides, GA & Pawlik, TM 2015, 'Outcomes after resection of cortisol-secreting adrenocortical carcinoma', American Journal of Surgery. https://doi.org/10.1016/j.amjsurg.2015.09.020

@article{e3645d57475043399c0d9d584bba3f10,

title = "Outcomes after resection of cortisol-secreting adrenocortical carcinoma",

abstract = "Background: We sought to define the impact of cortisol-secreting status on outcomes after surgical resection of adrenocortical carcinoma (ACC). Methods: The U.S ACC group database was queried to identify patients who underwent ACC resection between 1993 and 2014. The short-term and long-term outcomes were assessed. Results: The incidence of all functional and cortisol-secreting tumors was 40.6% and 22.6%, respectively. On multivariable analysis, cortisol secretion remained associated with an increased risk of postoperative complications (odds ratio = 2.25, 95 % confidence interval = 1.04 to 4.88; P = .04). At a median follow-up of 17.6 months, 118 patients (50.4%) had developed a recurrence. On multivariable analysis, after adjusting for patient and disease-related factors cortisol secretion independently predicted shorter recurrence-free survival (Hazard ratio = 2.05, 95% confidence interval = 1.16 to 3.60; P = .01). Conclusions: Cortisol secretion was associated with an increased risk of postoperative morbidity. Recurrence remains high among patients with ACC after surgery; cortisol secretion was independently associated with a shorter recurrence-free survival. Tailoring postoperative surveillance of ACC patients based on their cortisol secreting status may be important.",

keywords = "Adrenocortical, Carcinoma, Cortisol, Outcomes",

author = "Margonis, {Georgios Antonios} and Yuhree Kim and Tran, {Thuy B.} and Postlewait, {Lauren M.} and Maithel, {Shishir K.} and Wang, {Tracy S.} and Glenn, {Jason A.} and Ioannis Hatzaras and Rivfka Shenoy and Phay, {John E.} and Kara Keplinger and Fields, {Ryan C.} and Jin, {Linda X.} and Weber, {Sharon M.} and Ahmed Salem and Sicklick, {Jason K.} and Shady Gad and Yopp, {Adam C.} and Mansour, {John C.} and Duh, {Quan Yang} and Natalie Seiser and Solorzano, {Carmen C.} and Kiernan, {Colleen M.} and Votanopoulos, {Konstantinos I.} and Levine, {Edward A.} and Poultsides, {George A.} and Pawlik, {Timothy M.}",

year = "2015",

month = jul,

day = "26",

doi = "10.1016/j.amjsurg.2015.09.020",

language = "English (US)",

journal = "American Journal of Surgery",

issn = "0002-9610",

publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Outcomes after resection of cortisol-secreting adrenocortical carcinoma

AU - Margonis, Georgios Antonios

AU - Kim, Yuhree

AU - Tran, Thuy B.

AU - Postlewait, Lauren M.

AU - Maithel, Shishir K.

AU - Wang, Tracy S.

AU - Glenn, Jason A.

AU - Hatzaras, Ioannis

AU - Shenoy, Rivfka

AU - Phay, John E.

AU - Keplinger, Kara

AU - Fields, Ryan C.

AU - Jin, Linda X.

AU - Weber, Sharon M.

AU - Salem, Ahmed

AU - Sicklick, Jason K.

AU - Gad, Shady

AU - Yopp, Adam C.

AU - Mansour, John C.

AU - Duh, Quan Yang

AU - Seiser, Natalie

AU - Solorzano, Carmen C.

AU - Kiernan, Colleen M.

AU - Votanopoulos, Konstantinos I.

AU - Levine, Edward A.

AU - Poultsides, George A.

AU - Pawlik, Timothy M.

PY - 2015/7/26

Y1 - 2015/7/26

N2 - Background: We sought to define the impact of cortisol-secreting status on outcomes after surgical resection of adrenocortical carcinoma (ACC). Methods: The U.S ACC group database was queried to identify patients who underwent ACC resection between 1993 and 2014. The short-term and long-term outcomes were assessed. Results: The incidence of all functional and cortisol-secreting tumors was 40.6% and 22.6%, respectively. On multivariable analysis, cortisol secretion remained associated with an increased risk of postoperative complications (odds ratio = 2.25, 95 % confidence interval = 1.04 to 4.88; P = .04). At a median follow-up of 17.6 months, 118 patients (50.4%) had developed a recurrence. On multivariable analysis, after adjusting for patient and disease-related factors cortisol secretion independently predicted shorter recurrence-free survival (Hazard ratio = 2.05, 95% confidence interval = 1.16 to 3.60; P = .01). Conclusions: Cortisol secretion was associated with an increased risk of postoperative morbidity. Recurrence remains high among patients with ACC after surgery; cortisol secretion was independently associated with a shorter recurrence-free survival. Tailoring postoperative surveillance of ACC patients based on their cortisol secreting status may be important.

AB - Background: We sought to define the impact of cortisol-secreting status on outcomes after surgical resection of adrenocortical carcinoma (ACC). Methods: The U.S ACC group database was queried to identify patients who underwent ACC resection between 1993 and 2014. The short-term and long-term outcomes were assessed. Results: The incidence of all functional and cortisol-secreting tumors was 40.6% and 22.6%, respectively. On multivariable analysis, cortisol secretion remained associated with an increased risk of postoperative complications (odds ratio = 2.25, 95 % confidence interval = 1.04 to 4.88; P = .04). At a median follow-up of 17.6 months, 118 patients (50.4%) had developed a recurrence. On multivariable analysis, after adjusting for patient and disease-related factors cortisol secretion independently predicted shorter recurrence-free survival (Hazard ratio = 2.05, 95% confidence interval = 1.16 to 3.60; P = .01). Conclusions: Cortisol secretion was associated with an increased risk of postoperative morbidity. Recurrence remains high among patients with ACC after surgery; cortisol secretion was independently associated with a shorter recurrence-free survival. Tailoring postoperative surveillance of ACC patients based on their cortisol secreting status may be important.

KW - Adrenocortical

KW - Carcinoma

KW - Cortisol

KW - Outcomes

UR - http://www.scopus.com/inward/record.url?scp=84956956561&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84956956561&partnerID=8YFLogxK

U2 - 10.1016/j.amjsurg.2015.09.020

DO - 10.1016/j.amjsurg.2015.09.020

M3 - Article

C2 - 26810939

AN - SCOPUS:84956956561

SN - 0002-9610

JO - American Journal of Surgery

JF - American Journal of Surgery

ER -

Outcomes after resection of cortisol-secreting adrenocortical carcinoma

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this