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Endocrine Abstracts (2024) 99 EP183 | DOI: 10.1530/endoabs.99.EP183

1Hospital das Clínicas, University of São Paulo School of Medicine, Division of Urology, São Paulo, Brazil; 2Hospital das Clínicas, University of São Paulo School of Medicine, Division of Pathology, São Paulo, Brazil; 3Hospital das Clínicas, University of São Paulo School of Medicine, Division of Pathology, São Paulo, Brazil; 4Hospital das Clínicas, University of São Paulo School of Medicine, Division of Endocrinology, São Paulo, Brazil


Adrenocortical Carcinoma (ACC) is a rare and lethal disease with a poor prognosis. This study aims to share our 41-year experience as a referral center, focusing on identifying risk factors associated with ACC mortality. Our retrospective analysis included a cohort of 150 adult patients with ACC in all stage categories, treated between 1981 and 2022. Tumor hormonal hypersecretion was observed in 78.6% of the patients, and the median age of diagnosis was 40 years. The majority presented as ENSAT III or IV (22.9% and 31.2%, respectively), and the overall mortality rate was 54.6%. Independent predictors of death were elevated secretion of cortisol (HR=2.0), androstenedione (HR=2.2), estradiol (HR=2.8), 17-OH progesterone (HR=2.0), and 11-deoxycortisol (HR=5.1), higher Weiss (HR=4.3), modified Weiss (HR=4.4), and Helsinki scores (HR=12.0), advanced ENSAT stage (HR=27.1), larger tumor size (HR=2.7), higher Ki-67% (HR=2.3), and incomplete surgical resection (HR=2.5). Mitosis >5/50HPF (HR=5.6), atypical mitosis (HR=2.3), confluent necrosis (HR=15.4), venous invasion (HR=2.8), and capsular invasion (HR=2.4), were also identified as independent predictors of death. Knowing the risk factors for ACC’s mortality may help determine the best treatment option.

Volume 99

26th European Congress of Endocrinology

Stockholm, Sweden
11 May 2024 - 14 May 2024

European Society of Endocrinology 

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