ECE2024 Eposter Presentations Endocrine-Related Cancer (90 abstracts)
Clinical and pathological predictors of death for adrenocortical carcinoma
Eduardo Pato 1 , Victor Srougi 1 , Claudia Zerbini 2 , Felipe Ledesma 3 , Fabio Tanno 1 , Madson Almeida 4 , William Nahas 1 , Ana Claudia Latronico 4 , Berenice Mendonca 4 , Jose Chambô 1 & Maria Candida Fragoso 4
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.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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