Differences in life expectancy of adrenocortical carcinoma patients vs. age‑ and sex-matched population controls

期刊论文
发表日期：

2024年8月12日

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Letizia Maria Ippolita Jannello,
Andrea Baudo,
Lukas Scheipner,
Mario de Angelis,
Carolin Siech,
Francesco Di Bello,
Jordan A. Goyal,
Kira Vitucci,
Zhe Tian,
Stefano Luzzago,
Francesco A. Mistretta,
Matteo Ferro,
Fred Saad,
Felix K. H. Chun,
Alberto Briganti,
Luca Carmignani,
Nicola Longo,
Ottavio de Cobelli,
Gennaro Musi,
Pierre I. Karakiewicz

摘要

Purpose

To quantify to what extent the 5-year overall survival (OS) of adrenocortical carcinoma (ACC) patients differs from age- and sex-matched population-based controls, especially when stage is considered.

Methods

We relied on the Surveillance, Epidemiology, and End Results database (2004–2020) to identify newly diagnosed (2004–2014) ACC patients. Subsequently, we compared OS between ACC patients relative to simulated age- and sex-matched controls (Monte Carlo simulation), according to Social Security Administration Life Tables (2004–2020).

Results

Of all 742 ACC patients, 301 (41%) harbored localized stage, 173 (23%) locally advanced stage, and 268 (36%) metastatic stage. At 5-years follow-up, ACC patients' OS was 33%. After stratification for stage, the 5-years OS was 55 vs. 31 vs. 8% in localized, locally advanced, and metastatic stages, respectively. Conversely, after Monte Carlo simulation of age- and sex-matched controls, OS at five-years was 93% in the entire simulated cohort vs. 94% in the simulated localized cohort vs. 92 and 92% in locally advanced and metastatic stage, respectively. The resulting differences in OS between ACC patients and age- and sex-matched population-based controls were 60 vs. 39 vs. 61 vs. 84% respectively in the overall cohort vs. localized vs. locally advanced vs. metastatic stage.

Conclusion

The most pronounced life expectancy detriment (84%) was recorded in metastatic ACC followed by locally advanced ACC patients (61%). Unfortunately, even in patients with localized ACC, life expectancy was 39% lower than that of the general population. Therefore, regardless of stage, ACC diagnosis results in a very pronounced detriment in life expectancy relative to the general population.