Major prognostic role of Ki67 in localized adrenocortical carcinoma after complete resection
Beuschlein, Felix; Weigel, Jens; Saeger, Wolfgang; Kroiss, Matthias; Wild, Vanessa; Daffara, Fulvia; Libé, Rosella; Ardito, Arianna; Ghuzlan, Abir Al; Quinkler, Marcus; Oßwald, Andrea; Ronchi, Cristina L.; De Krijger, Ronald; Feelders, Richard A.; Waldmann, Jens; Willenberg, Holger S.; Deutschbein, Timo; Stell, Anthony; Reincke, Martin; Papotti, Mauro; Baudin, Eric; Tissier, Frédérique; Haak, Harm R.; Loli, Paola; Terzolo, Massimo; Allolio, Bruno; Müller, Hans Helge; Fassnacht, Martin
(2015) Journal of Clinical Endocrinology and Metabolism, volume 100, issue 3, pp. 841 - 849
(Article)
Abstract
Background: Recurrence of adrenocortical carcinoma (ACC) even after complete (R0) resection occurs frequently. Objective: The aim of this study was to identify markers with prognostic value for patients in this clinical setting. Design, Setting, and Participants: From the German ACC registry, 319 patients with the European Network for the Study
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of Adrenal Tumors stage I-III were identified. As an independent validation cohort, 250 patients from three European countries were included. Outcome Measurements and Statistical Analysis: Clinical, histological, and immunohistochemical markers were correlated with recurrence-free (RFS) and overall survival (OS). Results: Although univariable analysis within the German cohort suggested several factors with potential prognostic power, upon multivariable adjustment only a few including age, tumor size, venous tumor thrombus (VTT), and the proliferation marker Ki67 retained significance. Among these, Ki67 provided the single best prognostic value for RFS (hazard ratio [HR] for recurrence, 1.042 per 1% increase; P <.0001) and OS (HR for death, 1.051; P <.0001) which was confirmed in the validation cohort. Accordingly, clinical outcome differed significantly between patients with Ki67
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Keywords: Biochemistry, Clinical Biochemistry, Endocrinology, Biochemistry, medical, Endocrinology, Diabetes and Metabolism, General Medicine
ISSN: 0021-972X
Publisher: The Endocrine Society
(Peer reviewed)