The Effect of Adrenalectomy on Overall Survival in Metastatic Adrenocortical Carcinoma
Authors' conclusion
The present results indicate a potential protective effect of adrenalectomy in mACC, particularly in patients exposed to systemic therapy and those with lung-only metastases.
Study context
- Population
- Patients aged ≥18 years with metastatic adrenocortical carcinoma (ACC) at initial presentation, treated 2004–2020, SEER database
- Participants
- 543 patients
- Exposure
- Adrenalectomy vs no adrenalectomy
- Adrenalectomyn = 194
- Outcome
- Overall mortality
Methodological detailspopulation-based, SEER database, multivariable Cox regression, landmark analyses
- Population-based
- SEER database
- Multivariable Cox regression
- Landmark analyses
Main finding
As reported in the abstract
Hazard ratio
0.39
P < 0.001
multivariable analysis
Hazard ratio
0.57
P = 0.002
3 months' landmark analysis
Observational data: associations, not effects.
Further findings
Overall mortality by subgroup, 3 months' landmark analyses (adrenalectomy vs no adrenalectomy)
- Patients exposed to systemic therapy: same association effect
- HR: 0.49; P < .001
- Contemporary patients (2012-2020): same association effect
- HR: 0.57; P = .004
- Historical patients (2004-2011): same association effect
- HR: 0.42; P < .001
- Lung-only solitary metastasis: same association effect
- HR: 0.50; P = .02
- Patients naive to systemic therapy: no statistically significant association
- HR: 0.68; P = .3
- Multiple metastatic sites: no statistically significant association
- HR: 0.55; P = .07
- Liver-only solitary metastasis: no statistically significant association
- HR: 0.98; P = .9
- Sensitivity analyses
Original publication
The Effect of Adrenalectomy on Overall Survival in Metastatic Adrenocortical Carcinoma. J Clin Endocrinol Metab. Published 20 August 2024. doi:10.
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