ECE2023 Rapid Communications Rapid Communications 11: Late Breaking (6 abstracts)
Prognostic parameters of adrenocortical carcinoma. Single-centre confirmatory study of GRAS and S-GRAS scoring systems
Judit Tőke 1,2,3 , Lilla Welsch 1,4 , Erik Bényei 1,4 , Zoltán Sápi 5 , Katalin Borka 6 , Gergely Huszty 7 , János Horányi 7 , Eszter Balázs 8 , András Laki 1 , Ildikó Kalina 8 , Andrea Uhlyarik 1 , Peter Igaz 1,2,3,9 & Miklós Tóth 1,2,3
1Semmelweis University, Department of Internal Medicine and Oncology, Budapest, Hungary; 2European Reference Network on Rare Endocrine Conditions; 3ENS@T Research Center of Excellence; 4Semmelweis University, Students’ Scientific Association; 5Semmelweis University, Department of Pathology and Experimental Cancer Research, Budapest, Hungary; 6Semmelweis University, Department of Pathology, Forensic and Insurance Medicine, Budapest, Hungary; 7Semmelweis University, Department of Surgery, Transplantation and Gastroenterology, Budapest, Hungary; 8Semmelweis University, Medical Imaging Centre, Budapest, Hungary; 9Semmelweis University, Department of Endocrinology, Budapest, Hungary
Introduction: Adrenocortical carcinoma (ACC) is a rare disease with a poor prognosis. In recent years, two prognostic scoring systems incorporating relevant clinicopathological features of ACC (ENSAT stage, grade, resection status, age at diagnosis, tumour symptoms) have been proposed: the GRAS and S-GRAS scoring systems. The prognostic value of these systems has been demonstrated in large, multicentre studies.
Aim: To su mmarize the clinicopathological features of ACC patients treated in our centre, to determine the individual prognostic value of each feature, and to compare these values with the prognostic value of the calculated GRAS and S-GRAS scores, and thus to validate them on a single-centre patient population.
Methods: For our retrospective study, we used data from 86 patients with ACC treated at Semmelweis University, Hungary between 01/01/2000 and 31/08/2022. Descriptive statistical methods were used to su mmarize clinicopathological characteristics. To determine the correlation of data with survival, we performed Kaplan-Meier survival analysis using a log-rank test and univariate Cox regression. For statistical calculations, P<0.05 was considered significant.
Results: The mean age of the patients at diagnosis was 50.9±15.21 years. At baseline, the most frequent clinicopathological features were ENSAT stage IV (n=33), R0 resection status (n=34) and cortisol excess (n=48). Of the parameters studied, a significantly increased risk of mortality was associated with cortisol excess (RR=2.87 P<0.001), higher (III-IV) ENSAT stage (RR=2.2, P=0.002), R1/2 resection status (RR=2.42, P=0.001) and Ki67 index above 10% (RR=3.82, P=0.012). Among the prognostic scores, a high GRAS score (3-4 points) (RR=2.6, P<0.001) and a high S-GRAS score (5-9 points, 7-9 points) (RR=2.47, P<0.005, RR=9.45, P<0.001) were associated with a higher risk of death.
Conclusions: Among the studied parameters, tumour grade, resection status, cortisol production and tumour stage could be considered independent prognostic factors. High GRAS and high S-GRAS scores were associated with poorer overall survival and increased mortality risk. The clinical applicability of these scoring systems is enhanced by the fact that their prognostic value was also confirmed in a single-centre study with a relatively low number of patients.
Volume 90
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Endocrine Abstracts
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