Diagnosis,Treatment,and Prognosis For Adrenocortical Carcinoma

Objective: This study mainly aimed at investigating the characteristics of imaging and pathology in adrenocortical carcinoma(ACC),and those factors related to the prognosis of patients with ACC.Method: We conducted a retrospective study involving 35 ACC patients who had accepted treatment at Tongji Hospital from January 2006 to October 2016 and performed postoperative follow-up.The pathological and imaging features of these patients were summarized.The patient was followed up through phone call,and the survival analysis was performed based on the data obtained from the feedback to explore the relevant factors affecting the prognosis of the patient.Result: Thirty-three patients underwent surgery,4 of whom failed to completely remove the tumor,and the remaining patients underwent complete tumor resection.Patients who underwent cytoreductive surgery died within 14 months after surgery,with an average survival of 12.5months.Thirty patients were followed up in all patients,5 were lost to follow-up,and the follow-up time was 10 to 132 months.Univariate survival analysis of patients showed that there existed no significant difference in the survival of different gender groups,different age groups (? 50 years and < 50 years),different tumor location groups,different tumor size groups(maximum diameter ? 10 cm and < 10cm),different Ki-67 index groups(? 20 and(27)20),different surgical method groups,different intraoperative blood loss groups,and different ENSAT staging groups(P < 0.05),while the survival of the two groups with different operative time(?180 min and < 180 min)was statistically significant(P< 0.05),and the prognosis of subgroup with less time was better than the subgroup with more time.Conclusion: For patients with ACC who choose surgical treatment,the specific surgical method should be determined individually according to the specific situation.The earlier the tumor stage is,the better the prognosis is.The patient with complete tumor resection has better prognosis than the patient who only undergoes tumor debulking.