Clinical and outcome characteristics of children with adrenocortical tumors: A report from the international pediatric adrenocortical tumor registry

Clinical and outcome characteristics of children with adrenocortical tumors: A report from the international pediatric adrenocortical tumor registry

Author Michalkiewicz, E. Google Scholar
Sandrini, R. Google Scholar
Figueiredo, B. Google Scholar
Miranda, ECM Google Scholar
Caran, E. Google Scholar
Oliveira-Filho, A. G. Google Scholar
Marques, R. Google Scholar
Pianovski, MAD Google Scholar
Lacerda, L. Google Scholar
Cristofani, L. M. Google Scholar
Jenkins, J. Google Scholar
Rodriguez-Galindo, C. Google Scholar
Ribeiro, R. C. Google Scholar
Institution St Jude Childrens Res Hosp
Erasto Gaertner Hosp
Univ Fed Parana
Universidade Estadual de Campinas (UNICAMP)
Universidade Federal de São Paulo (UNIFESP)
Universidade de São Paulo (USP)
Univ Tennessee
Abstract Purpose We created a registry for pediatric adrenocortical tumors (ACTS), which are rare and are not well characterized. We provide a descriptive analysis of 254 patients registered on the International Pediatric Adrenocortical Tumor Registry.Patients and Methods Between January 1990 and December 2001, 254 patients younger than 20 years of age with newly diagnosed or previously treated ACTs were registered. A histologic diagnosis of ACT was required, although central review was not mandatory. Follow-up information was periodically requested from the referring physician. Treatment was chosen by the primary physician.Results the overall female-male ratio was 1.6:1, but it varied widely among age groups. the most common presenting sign (84.2%) was virilization. Cushing's syndrome without virilization was uncommon (5.5%). Tumors were completely resected in 83% of patients. Patients with disseminated or residual disease received mitotane, cisplatin, etoposide, and/or doxorubicin, and rarely, radiation therapy. At a median follow-up of 2 years and 5 months, 157 patients (61.8%) survived without evidence of disease and 97 patients (38.2%) had died. the 5-year event-free survival estimate was 54.2% (95% Cl, 48.2% to 60.2%). in a multivariate analysis, disease stage, presenting signs of endocrine dysfunction, and age were independently associated with prognosis.Conclusion Childhood ACTS occur predominantly in females and almost always causes clinical signs. Complete resection is required for cure. Residual or metastatic disease carries a poor prognosis. Our results demonstrate the feasibility of a disease-specific database for obtaining meaningful clinical and outcome information.(C) 2004 by American Society of Clinical Oncology.
Language English
Date 2004-03-01
Published in Journal of Clinical Oncology. Alexandria: Amer Soc Clinical Oncology, v. 22, n. 5, p. 838-845, 2004.
ISSN 0732-183X (Sherpa/Romeo, impact factor)
Publisher Amer Soc Clinical Oncology
Extent 838-845
Access rights Closed access
Type Article
Web of Science ID WOS:000189380900013

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