{"doi":"10.1210/clinem/dgab865","title":"Cytoreductive Surgery of the Primary Tumor in Metastatic Adrenocortical Carcinoma: Impact on Patients’ Survival","abstract":"CONTEXT: The role of cytoreduction of adrenocortical carcinoma (ACC) remains poorly understood. OBJECTIVE: To analyze the impact of cytoreductive surgery of the primary tumor in patients with metastatic ACC. DESIGN AND SETTING: We performed a multicentric, retrospective paired cohort study comparing the overall survival (OS) in patients with metastatic ACC who were treated either with cytoreductive surgery (CR group) or without cytoreductive surgery (no-CR group) of the primary tumor. Data were retrieved from 9 referral centers in the American-Australian-Asian Adrenal Alliance collaborative research group. PATIENTS: Patients aged ≥18 years with metastatic ACC at initial presentation who were treated between January 1, 1995, and May 31, 2019. INTERVENTION: Performance (or not) of cytoreductive surgery of the primary tumor. MAIN OUTCOME AND MEASURES: A propensity score match was done using age and the number of organs with metastasis (≤2 or >2). The main outcome was OS, determined from the date of diagnosis until death or until last follow-up for living patients. RESULTS: Of 339 patients pooled, 239 were paired and included: 128 in the CR group and 111 in the no-CR group. The mean follow-up was 67 months. Patients in the no-CR group had greater risk of death than did patients in the CR group (hazard ratio [HR] = 3.18; 95% CI, 2.34-4.32). Independent predictors of survival included age (HR = 1.02; 95% CI, 1.00-1.03), hormone excess (HR = 2.56; 95% CI, 1.66-3.92), and local metastasis therapy (HR = 0.41; 95% CI, 0.47-0.65). CONCLUSION: Cytoreductive surgery of the primary tumor in patients with metastatic ACC is associated with prolonged survival.","journal":"The Journal of Clinical Endocrinology & Metabolism","year":2021,"id":160991,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":31,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9575,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":239586,"name":"Irina Bancos","orcid":"0000-0001-9332-2524","position":1,"is_corresponding":false},{"id":347711,"name":"Marilyne Daher","orcid":"0000-0003-2825-2210","position":2,"is_corresponding":false},{"id":90463,"name":"J. E. Lee","orcid":"0000-0001-6010-5590","position":3,"is_corresponding":false},{"id":476569,"name":"Paul H. Graham","orcid":"0000-0002-8229-8765","position":4,"is_corresponding":false},{"id":261740,"name":"José A. Karam","orcid":"0000-0001-7697-9591","position":5,"is_corresponding":false},{"id":675137,"name":"Andres R. Henriquez","orcid":"0000-0002-1917-4153","position":6,"is_corresponding":false},{"id":253558,"name":"Travis J. McKenzie","orcid":"0000-0002-1343-6941","position":7,"is_corresponding":false},{"id":675138,"name":"Alaa Sada","orcid":"0000-0002-6000-5597","position":8,"is_corresponding":false},{"id":399739,"name":"Isabelle Bourdeau","orcid":"0000-0002-8000-4313","position":9,"is_corresponding":false},{"id":675139,"name":"Jonathan Poirier","orcid":"0000-0003-0140-1247","position":10,"is_corresponding":false},{"id":263020,"name":"Anand Vaidya","orcid":"0000-0002-0314-9252","position":11,"is_corresponding":false},{"id":338416,"name":"Tiffany Abbondanza","orcid":null,"position":12,"is_corresponding":false},{"id":676003,"name":"Colleen M. Kiernan","orcid":null,"position":13,"is_corresponding":false},{"id":675140,"name":"Sarika Rao","orcid":"0000-0003-2141-1696","position":14,"is_corresponding":false},{"id":511501,"name":"Oksana Hamidi","orcid":"0000-0002-7367-3885","position":15,"is_corresponding":false},{"id":675141,"name":"Nirupa Sachithanandan","orcid":"0000-0002-5074-0846","position":16,"is_corresponding":false},{"id":675142,"name":"Ana O. Hoff","orcid":"0000-0002-7058-6321","position":17,"is_corresponding":false},{"id":676004,"name":"Jose L Chambô","orcid":null,"position":18,"is_corresponding":false},{"id":370992,"name":"Madson Q. Almeida","orcid":"0000-0002-2957-6148","position":19,"is_corresponding":false},{"id":266118,"name":"Mouhammed Amir Habra","orcid":"0000-0002-4148-9637","position":20,"is_corresponding":false},{"id":239625,"name":"Maria Candida Barisson Villares Fragoso","orcid":"0000-0001-6150-1915","position":21,"is_corresponding":false},{"id":675136,"name":"Victor Srougi","orcid":"0000-0001-8346-3833","position":0,"is_corresponding":true}],"reference_count":25,"raw_metadata":null,"created_at":"2026-07-18T23:44:52.299342Z","pmid":"34850915","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}