Survival impact of treatment utilization and margin status after resection of adrenocortical carcinoma.

IF 2.7 3区医学 Q1 SURGERY American journal of surgery Pub Date : 2024-10-05 DOI:10.1016/j.amjsurg.2024.115999

Kelvin Memeh, Sara Abou Azar, Oluwasegun Afolaranmi, Tanaz M Vaghaiwalla

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引用次数: 0

Abstract

Background: This study examines the combined impact of margin status and adjuvant therapy utilization on overall survival (OS) for adrenocortical carcinoma (ACC) patients undergoing surgery with curative intent.

Methods: The 2004-2020 National Cancer Database (NCDB) was queried for ACC patients ≥18yrs undergoing curative surgery (no debulking), subdivided into R0 and R1/R2-groups, and analyzed using inverse-probability-weighted Cox Proportional Hazard-model.

Results: Of 5023 ACC patients, 3193 underwent curative surgery, 2213 (69 %) had R0 margins. Compared to the R0, the R1/R2 group had a decreased OS by 15.6 months (HR = 1.89, p = 0.002). While there has been no significant improvement in margin status over the years studied (2008-2017), there has been an overall increase in the proportion of patients receiving adjuvant therapy regardless of margin status, and the adverse impact of a positive margin on survival has decreased [HR 2.20 vs 1.76] CONCLUSIONS: R1/R2 margins are associated with decreased OS. The adverse impact of R1/R2 margins on OS decreased over time while adjuvant therapy utilization increased for all patients.

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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.