OR29-3 Prognostic value of histological markers in localized adrenocortical carcinoma after complete resection

Program: Abstracts - Orals, Featured Poster Presentations, and Posters
Session: OR29-Adrenal Tumors & Pheochromocytoma
Monday, June 17, 2013: 11:15 AM-12:45 PM
Presentation Start Time: 11:45 AM
Room 134 (Moscone Center)
Felix Beuschlein1, J Obracay2, Wolfgang Saeger3, Matthias Kroiss2, Marcus Quinkler4, Urs Daniel Lichtenauer5, Timo Deutschbein6, Cristina Lucia Ronchi2, Holger Willenberg7, Nicole Reisch8, Martin Reincke1, Rossella Libe9, Eric Baudin10, Jerome Yves Bertherat11, Harm Haak12, Richard Abraham Feelders13, Ronald de Krijger14, Paola Loli15, Massimo Terzolo*16, Bruno Allolio6, Hans-Helge Mueller17 and Martin Fassnacht1
1University of Munich, Munich, Germany, 2University Hospital Wuerzburg, 3Marienhospital Hamburg, 4Charite Campus Mitte, Berlin, Germany, 5LMU Campus City Center, Munich, Germany, 6University of Wuerzburg, Wuerzburg, Germany, 7University Hospital Duesseldorf, Duesseldorf, Germany, 8University Clinic Munich, 9Institut Cochin, France, France, 10Institut Gustave-Roussy, Paris, France, 11Hopital Cochin, Paris, France, 12Maxima Medisch Centrum, Eindhoven, Netherlands, 13Erasmus MC, Rotterdam, Netherlands, 14Erasmus MC, 15Niguarda Ca Granda Hosp, Milan, Italy, 16University of Turin, Orbassano, Italy, 17IBE - Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie
Purpose: Even after microscopically complete (R0) resection recurrence of adrenocortical carcinoma (ACC) is frequent. Here we aim at identification of histological parameters with potential prognostic value. Patients and Methods: 318 patients with European Network for the Study of Adrenal Tumours (ENSAT) stage I-III ACC after R0 resection were identified in the German ACC registry and tumour histology reviewed. Histological markers were correlated with recurrence free and overall survival. As an independent validation cohort, we analyzed 250 patients from six European centers. Results: Within the German cohort, univariate analysis identified age at diagnosis, tumor size and lymph node positivity (and correspondingly ENSAT stage) as markers with predictive value for recurrence free survival (RFS). Ki67 index provided the single best prognostic value for recurrence free survival (HR 1.042 per % increase for the German cohort and HR 1.024 for the validation cohort; p<0.001) which was superior to markers evaluated for calculation of the Weiss score. Following multivariate analysis including age, tumor size and adjuvant mitotane treatment Ki67 index remained informative. Similar results were obtainable for overall survival (HR 1.051 per % increase for the German cohort and HR 1.023 for the validation cohort; p<0.001). Conclusion: In conclusion, Ki67 was identified as the single most important prognostic marker for disease recurrence in ACC patients following R0 resection. Our findings will help to guide decisions on adjuvant therapy for this rare disease in the future.

Disclosure: RAF: Clinical Researcher, Novartis Pharmaceuticals, Speaker, Novartis Pharmaceuticals. MT: Ad Hoc Consultant, HRA Pharma. Nothing to Disclose: FB, JO, WS, MK, MQ, UDL, TD, CLR, HW, NR, MR, RL, EB, JYB, HH, RD, PL, BA, HHM, MF

*Please take note of The Endocrine Society's News Embargo Policy at http://www.endo-society.org/endo2013/media.cfm