When someone is diagnosed with a rare disease, cancer, or really any health-related issues, they tend to question what comes next. How will this condition impact them? What is their prognosis? It can be frightening to grapple with these questions and search for answers. A research team, while performing a retrospective data analysis, recently sought to better understand the prognosis and outcomes of adrenocortical carcinoma.
Studying Adrenocortical Carcinoma
As first reported by Healio, this data analysis included information from 512 adults living with adrenocortical carcinoma. A slight majority were female. This rare cancer occurs when a tumor forms on the adrenal gland, which is normally responsible for hormone production. Once this tumor forms, the adrenal gland begins to overproduce certain hormones like cortisol, aldosterone, and testosterone. Symptoms vary based on which hormone is overproduced but can include everything from abdominal and back pain and an abdominal lump to high blood pressure, weight gain, muscle weakness, acne, irregular periods, and frequent urination. There are available treatment options, such as surgery, radiation, and chemotherapy. But research continues to search for more effective treatment options.
The Most Impactful Findings
After exploring the data, the research team identified differences in outcome and presentation through the various cases. For example, adrenocortical carcinoma was described as an incidental finding in 38.1% of patients. This means that it was found as “something extra” when doctors ran tests searching for something else. Incidental findings of this cancer were more common in older individuals. The data also found that people whose cancer was discovered incidentally often live(d) longer than people who had associated symptoms, as did people whose cancer was in earlier stages (I/II).
Regarding treatment of the tumor, laparoscopic surgery was typically used for stage I adrenocortical carcinoma, whereas open surgery was more commonly utilized in more advanced cancer. After undergoing surgery, 62.7% of patients received adjuvant mitotane, with significantly more people with advanced cancer being prescribed the drug.
Additional findings, as published in The Journal of Clinical Endocrinology & Metabolism, show that 56.2% of people had their tumor recur within a median 15-month period. Only 33% of people had had no recurrence by five years. Adrenocortical carcinoma was fatal within five years in 38.1% of cases. The overall five-year survival rate was 54%, with people with stage I/II cancer tending to live longer. Localized disease in older individuals, later disease stages, adrenocortical cancer that returns, a higher Ki-67 response, and extra cortisol secretion all correlated with worse outcomes.
