{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T06:37:32Z","timestamp":1784875052099,"version":"3.55.0"},"reference-count":24,"publisher":"The Endocrine Society","issue":"3","license":[{"start":{"date-parts":[[2024,8,20]],"date-time":"2024-08-20T00:00:00Z","timestamp":1724112000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,2,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Although complete surgical resection provides the only means of cure in adrenocortical carcinoma (ACC), the magnitude of the survival benefit of adrenalectomy in metastatic ACC (mACC) is unknown.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>This work aimed to assess the effect of adrenalectomy on survival outcomes in patients with mACC in a real-world setting.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Patients with mACC aged 18 years or older with metastatic ACC at initial presentation who were treated between 2004 and 2020 were identified within the Surveillance, Epidemiology, and End Results database (SEER 2004-2020), and we tested for differences according to adrenalectomy status. Intervention included primary tumor resection status (adrenalectomy vs no adrenalectomy). Kaplan-Meier plots, multivariable Cox regression models, and landmark analyses were used. Sensitivity analyses focused on use of systemic therapy, contemporary (2012-2020) vs historical (2004-2011), single vs multiple metastatic sites, and assessable specific solitary metastatic sites (lung only and liver only).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 543 patients with mACC, 194 (36%) underwent adrenalectomy. In multivariable analyses, adrenalectomy was associated with lower overall mortality without (hazard ratio [HR]: 0.39; P &amp;lt; .001), as well as with 3 months' landmark analyses (HR: 0.57; P = .002). The same association effect with 3 months' landmark analyses was recorded in patients exposed to systemic therapy (HR: 0.49; P &amp;lt; .001), contemporary patients (HR: 0.57; P = .004), historical patients (HR: 0.42; P &amp;lt; .001), and in those with lung-only solitary metastasis (HR: 0.50; P = .02). In contrast, no statistically significant association was recorded in patients naive to systemic therapy (HR: 0.68; P = .3), those with multiple metastatic sites (HR: 0.55; P = .07), and those with liver-only solitary metastasis (HR: 0.98; P = .9).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The present results indicate a potential protective effect of adrenalectomy in mACC, particularly in patients exposed to systemic therapy and those with lung-only metastases.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/clinem\/dgae571","type":"journal-article","created":{"date-parts":[[2024,8,17]],"date-time":"2024-08-17T14:42:48Z","timestamp":1723905768000},"page":"748-757","source":"Crossref","is-referenced-by-count":5,"title":["The Effect of Adrenalectomy on Overall Survival in Metastatic Adrenocortical Carcinoma"],"prefix":"10.1210","volume":"110","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-9655-9451","authenticated-orcid":false,"given":"Anis","family":"Assad","sequence":"first","affiliation":[{"name":"Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montr\u00e9al Health Center , Montr\u00e9al, Qu\u00e9bec H2X 0A9 ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8577-2274","authenticated-orcid":false,"given":"Reha-Baris","family":"Incesu","sequence":"additional","affiliation":[{"name":"Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montr\u00e9al Health Center , Montr\u00e9al, Qu\u00e9bec H2X 0A9 ,","place":["Canada"]},{"name":"Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf , 20246 Hamburg ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Morra","sequence":"additional","affiliation":[{"name":"Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montr\u00e9al Health Center , Montr\u00e9al, Qu\u00e9bec H2X 0A9 ,","place":["Canada"]},{"name":"Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II , 80131 Naples ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"Scheipner","sequence":"additional","affiliation":[{"name":"Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montr\u00e9al Health Center , Montr\u00e9al, Qu\u00e9bec H2X 0A9 ,","place":["Canada"]},{"name":"Department of Urology, Medical University of Graz , 8036 Graz ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0746-2876","authenticated-orcid":false,"given":"Andrea","family":"Baudo","sequence":"additional","affiliation":[{"name":"Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montr\u00e9al Health Center , Montr\u00e9al, Qu\u00e9bec H2X 0A9 ,","place":["Canada"]},{"name":"Department of Urology, IRCCS Ospedale Galeazzi\u2013Sant\u2019Ambrogio , 20157 Milan ,","place":["Italy"]},{"name":"Department of Urology, IRCCS Policlinico San Donato , 20097 Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolin","family":"Siech","sequence":"additional","affiliation":[{"name":"Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montr\u00e9al Health Center , Montr\u00e9al, Qu\u00e9bec H2X 0A9 ,","place":["Canada"]},{"name":"Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main , 60323 Frankfurt am Main ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"De Angelis","sequence":"additional","affiliation":[{"name":"Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montr\u00e9al Health Center , Montr\u00e9al, Qu\u00e9bec H2X 0A9 ,","place":["Canada"]},{"name":"Unit of Urology\/Division of Oncology, Gianfranco Soldera Prostate Cancer Lab, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University , 20132 Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhe","family":"Tian","sequence":"additional","affiliation":[{"name":"Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montr\u00e9al Health Center , Montr\u00e9al, Qu\u00e9bec H2X 0A9 ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3158-5470","authenticated-orcid":false,"given":"Sascha","family":"Ahyai","sequence":"additional","affiliation":[{"name":"Department of Urology, Medical University of Graz , 8036 Graz ,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Longo","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II , 80131 Naples ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix K H","family":"Chun","sequence":"additional","affiliation":[{"name":"Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main , 60323 Frankfurt am Main ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahrokh F","family":"Shariat","sequence":"additional","affiliation":[{"name":"Department of Urology, Comprehensive Cancer Center, Medical University of Vienna , 1090 Vienna ,","place":["Austria"]},{"name":"Department of Urology, Weill Cornell Medical College , New York, 10065 NY ,","place":["USA"]},{"name":"Department of Urology, University of Texas Southwestern Medical Center , Dallas, TX 75390 ,","place":["USA"]},{"name":"Hourani Center of Applied Scientific Research, Al-Ahliyya Amman University , 19328 Amman ,","place":["Jordan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7033-1380","authenticated-orcid":false,"given":"Derya","family":"Tilki","sequence":"additional","affiliation":[{"name":"Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf , 20246 Hamburg ,","place":["Germany"]},{"name":"Department of Urology, University Hospital Hamburg-Eppendorf , 20246 Hamburg ,","place":["Germany"]},{"name":"Department of Urology, Koc University Hospital , 34010 Istanbul ,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2178-0494","authenticated-orcid":false,"given":"Alberto","family":"Briganti","sequence":"additional","affiliation":[{"name":"Unit of Urology\/Division of Oncology, Gianfranco Soldera Prostate Cancer Lab, IRCCS San Raffaele Scientific Institute, Milan, Italy; 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