Survival impact of treatment utilization and margin status after resection of adrenocortical carcinoma.

Autor: Memeh K; Department of Surgery, Methodist University Hospital, Memphis, TN, USA., Abou Azar S; Division of Endocrine Surgery, Department of Surgery, University of Chicago Medicine, Chicago, IL, USA., Afolaranmi O; Cancer Research UK Cambridge Institute University of Cambridge, GB, United Kingdom., Vaghaiwalla TM; Division of Endocrine Surgery, DeWitt Daughtry Family Department of Surgery, University of Miami, Miami, FL, USA. Electronic address: tmv12@med.miami.edu.
Jazyk: angličtina
Zdroj: American journal of surgery [Am J Surg] 2025 Jan; Vol. 239, pp. 115999. Date of Electronic Publication: 2024 Oct 05.
DOI: 10.1016/j.amjsurg.2024.115999
Abstrakt: Background: This study examines the combined impact of margin status and adjuvant therapy utilization on overall survival (OS) for adrenocortical carcinoma (ACC) patients undergoing surgery with curative intent.
Methods: The 2004-2020 National Cancer Database (NCDB) was queried for ACC patients ≥18yrs undergoing curative surgery (no debulking), subdivided into R0 and R1/R2-groups, and analyzed using inverse-probability-weighted Cox Proportional Hazard-model.
Results: Of 5023 ACC patients, 3193 underwent curative surgery, 2213 (69 ​%) had R0 margins. Compared to the R0, the R1/R2 group had a decreased OS by 15.6 months (HR ​= ​1.89, p ​= ​0.002). While there has been no significant improvement in margin status over the years studied (2008-2017), there has been an overall increase in the proportion of patients receiving adjuvant therapy regardless of margin status, and the adverse impact of a positive margin on survival has decreased [HR 2.20 vs 1.76] CONCLUSIONS: R1/R2 margins are associated with decreased OS. The adverse impact of R1/R2 margins on OS decreased over time while adjuvant therapy utilization increased for all patients.
Competing Interests: Declaration of competing interest This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The authors declare that they have no conflict of interest.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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