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 & 7 others Natalie Seiser, Carmen C. Solorzano, Colleen M. Kiernan, Konstantinos I. Votanopoulos, Edward A. Levine, George A. Poultsides, Timothy M. Pawlik

Research output: Contribution to journalArticle

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 languageEnglish (US)
JournalAmerican Journal of Surgery
DOIs
StateAccepted/In press - Jul 26 2015

Fingerprint

Adrenocortical Carcinoma
Hydrocortisone
Recurrence
Confidence Intervals
Survival
Odds Ratio
Databases
Morbidity
Incidence

Keywords

  • Adrenocortical
  • Carcinoma
  • Cortisol
  • Outcomes

ASJC Scopus subject areas

  • Surgery

Cite this

Margonis, G. A., Kim, Y., Tran, T. B., Postlewait, L. M., Maithel, S. K., Wang, T. S., ... 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

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

In: American Journal of Surgery, 26.07.2015.

Research output: Contribution to journalArticle

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
Margonis, Georgios Antonios ; Kim, Yuhree ; Tran, Thuy B. ; Postlewait, Lauren M. ; Maithel, Shishir K. ; Wang, Tracy S. ; Glenn, Jason A. ; Hatzaras, Ioannis ; Shenoy, Rivfka ; Phay, John E. ; Keplinger, Kara ; Fields, Ryan C. ; Jin, Linda X. ; Weber, Sharon M. ; Salem, Ahmed ; Sicklick, Jason K. ; Gad, Shady ; Yopp, Adam C. ; Mansour, John C. ; Duh, Quan Yang ; Seiser, Natalie ; Solorzano, Carmen C. ; Kiernan, Colleen M. ; Votanopoulos, Konstantinos I. ; Levine, Edward A. ; Poultsides, George A. ; Pawlik, Timothy M. / Outcomes after resection of cortisol-secreting adrenocortical carcinoma. In: American Journal of Surgery. 2015.
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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",
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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

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