engleski

Prognostic value of Ki-67 and ENSAT stage on recurrence-free survival and overall survival in patients with adrenocortical carcinoma

Background: The adrenocortical carcinoma (ACC) is a rare malignancy with poor outcomes and overall survival of less than 40%. Different prognostic factors were evaluated in patients with ACC. We analyzed overall survival (OS) and recurrence-free survival (RFS) in patients with ACC depending on Ki-67 and ENSAT staging. Methods: We performed a retrospective study on 62 ACC patients treated at the Croatian Referral Center for adrenal gland disorders from 2005 to 2019. Six patients (10%) had ENSAT stage I disease, 30 patients (48%) stage II, 14 patients (23%) stage III and 12 patients (19%) stage IV. RFS was analyzed in 47 patients with the ACC ENSAT stage I-III and R0 resection. Based on Ki-67 patients were stratified in two groups: Ki-67 ≤ 10% and Ki-67 > 10%. Results: The mean age of patients was 49.1 ± 15.5 years and 70.9% were females. During the study, 15 patients died of whom 10 deaths were related to ACC. The mean OS was 83.3 ± 14.3 months, 153.7 ± 11.3 months, 77.1 ± 14.5 months and 19.7 ± 4.9 months for ENSAT stage I, II, III, and IV, respectively (P < 0.001). Disease recurrence was observed in 9 patients (19%) of whom two patients had Ki-67 ≤ 10%.The mean RFS was 68.3 ± 9.5 months, 109.9 ± 9.4 months and 82.4 ± 16.4 months for ENSAT stage I, II and III, respectively (P = 0.916). Ki-67>10% was associated with poorer survival (P = 0.04). Conclusion: Our data confirmed that the ENSAT stage and Ki-67 are major predictors of ACC patient’s survival. However, in our cohort of patients, Ki-67 has not been associated with the ACC recurrence.

adrenocortical carcinoma

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