Xiao Wen-jun, Zhu Yao, Dai Bo, Zhang Hai-liang, Shi Guo-hai, Shen Yi-jun, Zhu Yi-ping, Ye Ding-wei
Department of Urology, Fudan University Shanghai Cancer Centre, Shanghai 200032, People's Republic of China.
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, People's Republic of China.
Oncotarget. 2015 Dec 29;6(42):44955-62. doi: 10.18632/oncotarget.5831.
Surgical excision is essential for management of the rare and aggressive neoplasm adrenal cortical carcinoma (ACC). Five-year overall survival (OS) after surgery for ACC is dependent on disease stage, but for all stages the risk of death declines with time after surgery. We calculated the effect of post-surgical duration on conditional survival (CS) among ACC patients. A total of 641 patients with M0 ACC were selected from the Surveillance, Epidemiology, and End Results (SEER) registry (1988-2012). OS for the entire cohort at 1, 2, 3, 4, 5 and 6 years was 81.4%, 66.8%, 56.3%, 50.3%, 47.2% and 44.3%, respectively. CS for an additional year given prior survival for 0, 1, 2, 3, 4 or 5 years was 81.4%, 81.1%, 83.0%, 87.5%, 93.4% and 93.4%, respectively. Age, tumor stage, tumor grade and marital status affected OS and CS. Increases in 1-year CS over time were more pronounced in patients with poorer prognostic factors. With longer follow-up, tumor stage- and grade-dependent differences in CS decreased or even disappeared. CS may provide more meaningful life expectancy predictions for survivors of ACC than conventional survival analysis.
手术切除对于罕见且侵袭性强的肾上腺皮质癌（ACC）的治疗至关重要。ACC手术后的五年总生存率（OS）取决于疾病分期，但对于所有分期而言，术后死亡风险会随时间下降。我们计算了术后持续时间对ACC患者条件生存（CS）的影响。从监测、流行病学和最终结果（SEER）登记处（1988 - 2012年）选取了641例M0期ACC患者。整个队列在1年、2年、3年、4年、5年和6年时的OS分别为81.4%、66.8%、56.3%、50.3%、47.2%和44.3%。在已存活0年、1年、2年、3年、4年或5年的基础上再存活1年的CS分别为81.4%、81.1%、83.0%、87.5%、93.4%和93.4%。年龄、肿瘤分期、肿瘤分级和婚姻状况影响OS和CS。预后因素较差的患者随时间推移1年CS的增加更为明显。随着随访时间延长，CS中肿瘤分期和分级相关的差异减小甚至消失。与传统生存分析相比，CS可能为ACC幸存者提供更有意义的预期寿命预测。
