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Value of Molecular Classification for Prognostic Assessment of Adrenocortical Carcinoma
Value of Molecular Classification for Prognostic Assessment of Adrenocortical Carcinoma
- Source :
- JAMA Oncology, 5(10), 1440. American Medical Association, JAMA Oncol, JAMA Oncology, 5(10), 1440-1447. American Medical Association
- Publication Year :
- 2019
-
Abstract
- IMPORTANCE: The risk stratification of adrenocortical carcinoma (ACC) based on tumor proliferation index and stage is limited. Adjuvant therapy after surgery is recommended for most patients. Pan-genomic studies have identified distinct molecular groups closely associated with outcome. OBJECTIVE: To compare the molecular classification for prognostic assessment of ACC with other known prognostic factors. DESIGN, SETTING, AND PARTICIPANTS: In this retrospective biomarker analysis, ACC tumor samples from 368 patients who had undergone surgical tumor removal were collected from March 1, 2005, to September 30, 2015 (144 in the training cohort and 224 in the validation cohort) at 21 referral centers with a median follow-up of 35 months (interquartile range, 18-74 months). Data were analyzed from March 2016 to March 2018. EXPOSURES: Meta-analysis of pan-genomic studies (transcriptome, methylome, chromosome alteration, and mutational profiles) was performed on the training cohort. Targeted biomarker analysis, including targeted gene expression (BUB1B and PINK1), targeted methylation (PAX5, GSTP1, PYCARD, and PAX6), and targeted next-generation sequencing, was performed on the training and validation cohorts. MAIN OUTCOMES AND MEASURES: Disease-free survival. Cox proportional hazards regression and C indexes were used to assess the prognostic value of each model. RESULTS: Of the 368 patients (mean [SD] age, 49 [16] years), 144 were in the training cohort (100 [69.4%] female) and 224 were in the validation cohort (142 [63.4%] female). In the training cohort, pan-genomic measures classified ACC into 3 molecular groups (A1, A2, and A3-B), with 5-year survival of 9% for group A1, 45% for group A2, and 82% for group A3-B (log-rank P
- Subjects :
- Oncology
medicine.medical_specialty
Cancer Research
Mitotic index
Proliferation index
business.industry
Hazard ratio
medicine.disease
BUB1B
03 medical and health sciences
GSTP1
0302 clinical medicine
Interquartile range
030220 oncology & carcinogenesis
Internal medicine
medicine
Adjuvant therapy
Adrenocortical carcinoma
030212 general & internal medicine
business
Original Investigation
Subjects
Details
- Language :
- English
- ISSN :
- 23742437
- Database :
- OpenAIRE
- Journal :
- JAMA Oncology, 5(10), 1440. American Medical Association, JAMA Oncol, JAMA Oncology, 5(10), 1440-1447. American Medical Association
- Accession number :
- edsair.doi.dedup.....0b5ac73c5024050e6263ed05b3877800