Prognostic markers of recurrence in adrenocortical carcinoma patients after surgery
- Authors: Kalugina V.V.1, Vorokhobina N.V.1, Velikanova L.I.1, Shafigullina Z.R.1, Malevanaya E.V.1, Strelnikova E.G.1, Bokhyan V.Y.2, Britvin T.A.3, Kushlinskii N.E.2
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Affiliations:
- North-Western State Medical University named after I.I. Mechnikov
- N.N. Blokhin National Medical Research Center of Oncology
- Moscow Regional Research and Clinical Institute (MONIKI)
- Issue: Vol 15, No 2 (2023)
- Pages: 57-67
- Section: Original research
- URL: https://journals.rcsi.science/vszgmu/article/view/131105
- DOI: https://doi.org/10.17816/mechnikov233493
- ID: 131105
Cite item
Abstract
BACKGROUND: Adrenocortical carcinoma is a rare and aggressive disease. Tumor recurrence prevention is vital for increasing patients’ survival rate. Therefore, the identification of prognostic markers is of particular importance.
AIM: To evaluate clinical, laboratory and chromatographic criteria for adrenocortical carcinoma recurrence using gas chromatography-mass spectrometry to optimize patient’s follow-up.
MATERIALS AND METHODS: 40 patients [10 (25%) men and 30 (75%) women] with histologically confirmed adrenocortical carcinoma (according to the European Network for the Study of Adrenal Tumors stage I — 3, II — 29, III — 8 patients at presentation) have been recruited. Measurement of 24-hour urinary steroid metabolite excretion has been carried out by gas chromatography-mass spectrometry (GCMS-ТQ8050, Shimadzu) in preoperative period. The survival distribution has been assessed according to the Kaplan–Meier method. Cox proportional hazards regression methods have been used to determine predictive factors on recurrence-free survival.
RESULTS: The patients with early stages of disease (I–II versus III) had a significantly longer recurrence-free survival, overt hypercortisolism was associated with significantly shorter recurrence-free survival. A significant correlation between pregnenediol urinary excretion and tumor diameter, stage has been found. Increased urinary excretion of tetrahydro-11-deoxycortisol, pregnenediol was associated with a decreased recurrence-free survival in the patients with overt hypercortisolism. Increased urinary excretion of 16-OH-dehydroepiandrosterone was a marker of a shorter recurrence-free survival in the patients without Cushing syndrome. Increased urinary excretion of pregnenediol, pregnenetriol, 16-oxo-androstenediol in all the adrenocortical carcinoma patients was associated with a recurrence risk. In the multivariate analysis pregnenediol urinary excretion, stage and overt cortisol excess were significantly and independently associated with a shorter recurrence-free survival.
CONCLUSIONS: Adrenocortical carcinoma recurrence prognostic markers have been found by gas chromatography-mass spectrometry. The application of these findings may improve patient-centered outcomes.
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##article.viewOnOriginalSite##About the authors
Valentina V. Kalugina
North-Western State Medical University named after I.I. Mechnikov
Email: kaluginavav@gmail.com
ORCID iD: 0000-0002-2812-6911
SPIN-code: 3996-7284
MD
Russian Federation, Saint PetersburgNatalia V. Vorokhobina
North-Western State Medical University named after I.I. Mechnikov
Email: natvorokh@mail.ru
ORCID iD: 0000-0002-9574-105X
SPIN-code: 4062-6409
MD, Dr. Sci. (Med.), Professor
Russian Federation, Saint PetersburgLudmila I. Velikanova
North-Western State Medical University named after I.I. Mechnikov
Email: velikanova46@gmail.com
ORCID iD: 0000-0002-9352-4035
SPIN-code: 5586-4851
Scopus Author ID: 6701531680
Dr. Sci. (Biol.), Professor
Russian Federation, Saint PetersburgZulfiya R. Shafigullina
North-Western State Medical University named after I.I. Mechnikov
Email: zula183@mail.ru
ORCID iD: 0000-0001-8292-8504
SPIN-code: 7569-3823
MD, Cand. Sci. (Med.)
Russian Federation, Saint PetersburgEkaterina V. Malevanaya
North-Western State Medical University named after I.I. Mechnikov
Author for correspondence.
Email: e.malevanaia@gmail.com
ORCID iD: 0000-0003-0880-0814
SPIN-code: 8814-0716
Scopus Author ID: 55657420600
Cand. Sci. (Chem.)
Russian Federation, 41 Kirochnaya St., Saint Petersburg, 191015Elena G. Strelnikova
North-Western State Medical University named after I.I. Mechnikov
Email: lstrelnikova@inbox.ru
ORCID iD: 0000-0002-1208-8092
SPIN-code: 6631-6962
Scopus Author ID: 57190013028
Cand. Sci. (Chem.)
Russian Federation, Saint PetersburgVagan Yu. Bokhyan
N.N. Blokhin National Medical Research Center of Oncology
Email: v_bokhyan@kand.ru
ORCID iD: 0000-0002-9066-5190
SPIN-code: 1040-0138
Scopus Author ID: 6507344683
MD, Dr. Sci. (Med.)
Russian Federation, MoscowTimur A. Britvin
Moscow Regional Research and Clinical Institute (MONIKI)
Email: t.britvin@gmail.com
ORCID iD: 0000-0001-6160-1342
SPIN-code: 1207-2935
Scopus Author ID: 6506344903
MD, Dr. Sci. (Med.), Professor
Russian Federation, MoscowNikolay E. Kushlinskii
N.N. Blokhin National Medical Research Center of Oncology
Email: kne3108@gmail.com
ORCID iD: 0000-0002-3898-4127
SPIN-code: 6225-1487
Scopus Author ID: 7005430266
MD, Dr. Sci. (Med.), Professor, Academician of RAS
Russian Federation, MoscowReferences
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