AI Article Synopsis
- Adrenocortical carcinoma (ACC) is a rare and challenging cancer with poor survival rates, prompting an investigation into how treatment and outcomes differ between high-volume (HVC) and low-volume centers (LVC).
- Analysis of data from the National Cancer Database showed that patients treated at HVCs received more surgery and chemotherapy, and experienced lower 90-day readmission rates compared to those at LVCs.
- While there was no significant difference in overall survival for non-metastatic cases between HVCs and LVCs, patients with metastatic ACC at HVCs had better overall survival and lower 90-day mortality rates.
Article Abstract
Background: Adrenocortical carcinoma (ACC) is rare with poor survival. Do treatment and outcomes vary by volume?
Methods: NCDB (2004-2017) was searched for patients with ACC. High-volume centers (HVCs) were defined by ≥ 15 ACC and low-volume centers by ≤ 7 total cases. Multivariable Cox and logistic regression analysis were performed.
Results: ACC patients at HVCs were significantly more likely to have surgery, chemotherapy, and had lower 90-day readmission. HVCs were significantly more likely than LVCs to administer chemotherapy to surgical NonMetastatic (NM)-ACC patients. There was no significant difference in overall survival (OS), 90-day mortality, length of stay, or radiation treatments between the two. Operative Metastatic (M)-ACC at HVC had significantly improved OS, more chemotherapy administered, and lower 90-day mortality.
Conclusion: NM-ACC and M-ACC treated at HVCs were more likely to have surgery and multimodality therapy. NM-ACC having surgery at HVCs and LVCs had similar OS. M-ACC at HVCs had improved OS and 90-day mortality.
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| http://dx.doi.org/10.1016/j.amjsurg.2022.01.004 | DOI Listing |
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