Clinical Research Papers:
Conditional survival among patients with adrenal cortical carcinoma determined using a national population-based surveillance, epidemiology, and end results registry
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Wen-jun Xiao1,2, Yao Zhu1,2, Bo Dai1,2, Hai-liang Zhang1,2, Guo-hai Shi1,2, Yi-jun Shen1,2, Yi-ping Zhu1,2, Ding-wei Ye1,2
1Department of Urology, Fudan University Shanghai Cancer Centre, Shanghai 200032, People's Republic of China
2Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, People's Republic of China
Yao Zhu, e-mail: [email protected]
Ding-wei Ye, e-mail: [email protected]
Keywords: adrenal cortical carcinoma, conditional survival, overall survival, surgical excision
Received: July 14, 2014 Accepted: October 01, 2015 Published: October 14, 2015
Surgical excision is essential for management of the rare and aggressive neoplasm adrenal cortical carcinoma (ACC). Five-year overall survival (OS) after surgery for ACC is dependent on disease stage, but for all stages the risk of death declines with time after surgery. We calculated the effect of post-surgical duration on conditional survival (CS) among ACC patients. A total of 641 patients with M0 ACC were selected from the Surveillance, Epidemiology, and End Results (SEER) registry (1988–2012). OS for the entire cohort at 1, 2, 3, 4, 5 and 6 years was 81.4%, 66.8%, 56.3%, 50.3%, 47.2% and 44.3%, respectively. CS for an additional year given prior survival for 0, 1, 2, 3, 4 or 5 years was 81.4%, 81.1%, 83.0%, 87.5%, 93.4% and 93.4%, respectively. Age, tumor stage, tumor grade and marital status affected OS and CS. Increases in 1-year CS over time were more pronounced in patients with poorer prognostic factors. With longer follow-up, tumor stage- and grade-dependent differences in CS decreased or even disappeared. CS may provide more meaningful life expectancy predictions for survivors of ACC than conventional survival analysis.
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