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Impact of postoperative radiotherapy on the outcomes of resected adrenocortical carcinoma—a real-world, population-based study

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Abstract

Objective

To assess the impact of postoperative radiotherapy on the outcomes of resected adrenocortical carcinoma in a real-world setting.

Methods

The Surveillance, Epidemiology, and End Results Research Plus database was accessed, and patients with resected non-metastatic adrenocortical carcinoma diagnosed 2010–2015 were reviewed. Kaplan–Meier estimates and log-rank testing were used to examine the impact of postoperative radiotherapy on overall and cancer-specific survival. Multivariable Cox regression analysis was used to explore factors associated with overall and cancer-specific survival.

Results

A total of 294 patients were included in the final analysis, including 60 patients (20.4%) who received postoperative radiotherapy. Using Kaplan–Meier estimates, individuals who received postoperative radiotherapy have better overall survival (P = 0.002). Multivariable cox regression analysis showed that the following factors were associated with worse overall survival: older age (HR: 1.01; 95% CI: 1.00–1.03), male sex (HR for female sex versus male sex: 0.61; 95% CI: 0.43–0.85), and non-receipt of postoperative radiation therapy (HR: 2.29; 95% CI: 1.38–3.77). Systemic therapy was not associated with differences in overall survival (HR: 0.77; 95% CI: 0.54–1.10). Likewise, the following factors were associated with worse cancer-specific survival: male sex (HR for female sex versus male sex: 0.60; 95% CI: 0.41–0.88), non-receipt of postoperative radiation therapy (HR: 2.17; 95% CI: 1.27–3.70), and receipt of perioperative systemic therapy (HR: 0.67; 95% CI: 0.45–0.99).

Conclusion

Postoperative radiotherapy following resection of adrenocortical carcinoma is associated with better overall and cancer-specific survival.

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Authors and Affiliations

  1. Department of Oncology, Cross Cancer Institute, University of Alberta, T6G 1Z2, Edmonton, Alberta, Canada

    Omar Abdel-Rahman

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  1. Omar Abdel-Rahman
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Correspondence to Omar Abdel-Rahman.

Ethics declarations

Conflict of interest

O. Abdel-Rahman: Advisory board Eisai Canada, Lilly Canada, and Roche Canada.

Ethical standards

As this study is based on a publicly available database without identifying patient information, informed consent was not needed.

Supplementary Information

66_2021_1838_MOESM1_ESM.jpg

S. figure 1: Overall survival according to the use of postoperative radiation therapy (pre-propensity cohort) for a) patients with stage I–II.

66_2021_1838_MOESM2_ESM.jpg

S. figure 1: Overall survival according to the use of postoperative radiation therapy (pre-propensity cohort) for b) patients with stage III–IV.

S. figure 2: Overall survival according to the use of perioperative systemic therapy for a) patients with stage I–II.

S. figure 2: Overall survival according to the use of perioperative systemic therapy for b) patients with stage III–IV.

66_2021_1838_MOESM5_ESM.png

S. figure 3: Histogram for propensity score matching procedure (treated: i.e., treated with radiation therapy; control: not treated with radiation therapy).

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Abdel-Rahman, O. Impact of postoperative radiotherapy on the outcomes of resected adrenocortical carcinoma—a real-world, population-based study. Strahlenther Onkol 198, 73–79 (2022). https://doi.org/10.1007/s00066-021-01838-6

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  • DOI: https://doi.org/10.1007/s00066-021-01838-6

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