Risk factors associated with positive resection margins in patients with adrenocortical carcinoma.

Autor: Skertich NJ; Department of Surgery, Rush University Medical Center, 1750 W. Harrison, Suite 785, Chicago, IL, 60612, USA. Electronic address: Nicholas_J_Skertich@rush.edu., Tierney JF; Department of Surgery, Rush University Medical Center, 1750 W. Harrison, Suite 785, Chicago, IL, 60612, USA., Chivukula SV; Department of Surgery, Rush University Medical Center, 1750 W. Harrison, Suite 785, Chicago, IL, 60612, USA., Babazadeh NT; Department of Surgery, Rush University Medical Center, 1750 W. Harrison, Suite 785, Chicago, IL, 60612, USA., Hertl M; Department of Surgery, Division of Transplant Surgery, Rush University Medical Center, 1750 W. Harrison, Suite 785, Chicago, IL, 60612, USA., Poirier J; Department of Surgery, Rush University Medical Center, 1750 W. Harrison, Suite 785, Chicago, IL, 60612, USA., Keutgen XM; Department of Surgery, Division of General Surgery and Surgical Oncology, Endocrine Research Program, The University of Chicago Medicine and Biological Sciences Division, 5841 S. Maryland Ave, Chicago, IL, 60637, USA. Electronic address: xkeutgen@surgery.bsd.uchicago.edu.
Jazyk: angličtina
Zdroj: American journal of surgery [Am J Surg] 2020 Oct; Vol. 220 (4), pp. 932-937. Date of Electronic Publication: 2020 Feb 22.
DOI: 10.1016/j.amjsurg.2020.02.043
Abstrakt: Background: Positive resection margins are associated with worse survival after surgery for adrenocortical carcinoma (ACC). We aimed to identify risk factors for positive margins post-resection.
Methods: The NCDB was queried for ACC patients from 2006 to 2015. Patients with positive versus negative resection margins post-surgery were compared using Chi-square tests. Survival based on adjuvant treatment was assessed using Kaplan-Meier curves.
Results: 1,973 patients with ACC were identified, 217 (11.0%) with positive margins. Multivariable analysis identified extra-adrenal extension (HR 4.92, p < 0.001), lymph node metastases (HR 2.64, p = 0.001), and distant metastases (HR 1.53, p = 0.03) as risk factors for positive margins. No significant difference in margin status existed between patients who had an open versus minimally invasive procedure (p = 0.6). Positive margin patients receiving adjuvant radiation (p = 0.007) or combined chemo-radiation (p = 0.001) had the longest survival.
Conclusion: No modifiable risk factors were identified, but patients with positive margins receiving adjuvant radiation or chemo-radiation had the longest survival.
Competing Interests: Declaration of competing interest None.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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