Shotaro Nakanishi, Yumi Fukushima, Junichi Inokuchi, Tomoaki Hakariya, Hiroaki Kakinoki, Hideki Enokida, Katsuaki Chikui, Hirofumi Matsuoka, Toshitaka Shin, Shoichiro Mukai, Tomomi Kamba, Masatoshi Eto, Ryoichi Imamura, Mitsuru Noguchi, Tsukasa Igawa, Nobuhiro Haga, Toshiyuki Kamoto, Naohiro Fujimoto, Seiichi Saito

Clinicopathological characteristics of adrenocortical carcinoma in the Kyushu–Okinawa area of Japan

  • Urology

ObjectiveAdrenocortical carcinoma is a rare condition, with limited comprehensive reports from Japan. This study aimed to review Japan's data on adrenocortical carcinoma by assessing information from 46 patients—with adrenocortical carcinoma across 10 Japanese university hospitals.MethodsWe conducted a retrospective multi‐institutional analysis of the clinical characteristics of adrenocortical carcinoma in Japan. We evaluated data from 46 patients across 10 university hospitals over 10 years and analyzed the relationship between clinicopathological characteristics and overall survival.ResultsFive‐ and 10‐year overall survival rates were 59% and 53%, respectively. Overall survival was significantly different among the tumor–node–metastasis system for adrenocortical carcinoma of the American Joint Committee on Cancer/International Union Against Cancer, with the worst prognosis in stage IV (p = 0.0044). In our cohort, neither the Weiss score nor the Ki‐67 proliferation index correlated with overall survival. Adjuvant treatment did not yield improved overall survival, whereas resection of the primary tumor in stage IV disease was significantly associated with improved overall survival (p = 0.0262). Out of the cases evaluated for plasma hormones, plasma cortisol, aldosterone, testosterone, and DHEA‐S levels were measured at 23%, 42%, 29%, and 62%, respectively, demonstrating higher levels than the upper normal limits.ConclusionPatients with stage IV adrenocortical carcinoma had a poor prognosis; however, resection of the primary tumor in stage IV disease was associated with prolonged survival. The results of this study are expected to contribute to future treatment of adrenocortical carcinoma in Japan.

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