{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T23:56:00Z","timestamp":1793318160279,"version":"4.5.0"},"reference-count":39,"publisher":"The Endocrine Society","issue":"5","license":[{"start":{"date-parts":[[2022,1,29]],"date-time":"2022-01-29T00:00:00Z","timestamp":1643414400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["P30CA016672"],"award-info":[{"award-number":["P30CA016672"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["P30CA016672"],"award-info":[{"award-number":["P30CA016672"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,4,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Reporting temporal trends in adrenocortical carcinoma (ACC) helps guide management strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This work aimed to report the trends in disease burden and clinical outcomes over time that cannot be adequately captured from individual clinical trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective study was held of ACC patients seen at a referral cancer center between February 1998 and August 2019. Clinical outcomes were compared between an early cohort (February 1998-June 2007) and a late cohort (July 2007-August 2019).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 621 patients included with a median age at diagnosis of 49.3 years (range, 0.5-86.6 years). There were 285 (45.9%) patients with hormonal overproduction. More patients in the late cohort had stage IV disease compared to the early cohort (36.8% vs 23.1%; P\u2005&amp;lt;\u2005.0001). Resection of the primary tumor was performed in 502 patients (80.8%). Complete resection (R0) was more common in the late cohort (165 [60.2%]) than in the early cohort (100 [44.6%]; P\u2005=\u2005.0005). Of 475 patients with metastatic disease (stage IV or recurrent metastatic disease), 352 (74.1%) received mitotane, 320 (67.4%) received chemotherapy, and 53 (11.2%) received immunotherapy. In the early cohort, 70 (33%) received 2 or more lines of therapy, whereas in the late cohort, 127 (48%) received 2 or more lines of therapy. The 5-year overall survival (OS) rates were 65%, 58%, 45%, and 10% for stage I, II, III, and IV disease, respectively, whereas the 2-year OS rates in patients with stage IV disease was 24% in the early cohort and 46% in the late cohort (P\u2005=\u2005.01).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>ACC clinical outcomes improved over the past 2 decades as more patients had complete resection or received more lines of systemic therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/clinem\/dgac046","type":"journal-article","created":{"date-parts":[[2022,1,29]],"date-time":"2022-01-29T14:01:50Z","timestamp":1643464910000},"page":"1239-1246","source":"Crossref","is-referenced-by-count":36,"title":["Temporal Trends in Outcomes in Patients With Adrenocortical Carcinoma: A Multidisciplinary Referral-center 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Medicine, Houston, Texas 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina","family":"Altameemi","sequence":"additional","affiliation":[{"name":"Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hadil","family":"Bazerbashi","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aung","family":"Naing","sequence":"additional","affiliation":[{"name":"Department of Investigational Cancer Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivek","family":"Subbiah","sequence":"additional","affiliation":[{"name":"Department of Investigational Cancer 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A","family":"Sheth","sequence":"additional","affiliation":[{"name":"Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose A","family":"Karam","sequence":"additional","affiliation":[{"name":"Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA"},{"name":"Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher G","family":"Wood","sequence":"additional","affiliation":[{"name":"Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy D","family":"Perrier","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, The University of Texas 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