[Prognostic determinants of adrenocortical carcinoma in adults].

OBJECTIVE To investigate the clinical features and prognostic determinants of adrenocortical carcinoma (ACC) in adult patients. METHODS All adult patients (aged > or =18 years old) who were admitted to West China Hospital, Sichuan University from 1st Jan., 2000 to 31st Jan., 2013 with a pathologically diagnosed ACC were included in this study. Data about the demographics, clinical characteristics, laboratory examinations and outcomes of those patients were extracted and analyzed. RESULTS A total of 52 cases were identified, with a median follow-up of 26 months (3-159 months). The patients had a median survival time of 29 months (1-156 months), with a 1-year, 3-year; and 5-year survival rate of 71.0%, 47.0%, and 42.7%, respectively. In the univariate analysis, aged >45 years old at diagnosis (P = 0.017), advanced stage (III-IV stage, P<0.001), incomplete resection (P = 0.011), symptomatic (P = 0.017), hypoalbuminemia (P = 0.003), and elevated lactate dehydrogenase (LDH) (P = 0.017) were associated with poor prognosis of ACC. The multivariate analysis confirmed that hypoalbuminemia Chazard ratio (HR) = 5.306; 95% confidence interval (95% CI: 1.975, 14.258; P = 0.001), female (HR = 4.020; 95% CI: 1.610, 10.038; P = 0.003), advanced stage (HR = 7.405; 95% CI: 2.561, 21.410; P < 0.001), and older age (HR = 4.628; 95% CI: 1.791, 11.959; P = 0.002) were predictors of poor prognosis of ACC. CONCLUSION Hypoalbuminemia, female, older age, and advanced stage are independent risk factors associated with poor prognosis of ACC.in adult patients.