Identifying genomic signatures of recurrence in adrenocortical carcinoma after R0 resection.

IF 3.2 2区医学 Q1 SURGERY

Surgery Pub Date : 2024-10-19 DOI:10.1016/j.surg.2024.09.036

Benjamin C Greenspun, Dawn Chirko, Rajbir Toor, Kyle Wierzbicki, Teagan E Marshall, Abhinay Tumati, Rasa Zarnegar, Thomas J Fahey, Brendan M Finnerty

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引用次数: 0

Abstract

Background: Adrenocortical carcinoma (ACC) is a rare and aggressive malignancy with limited treatment options. Although there have been recent advancements revealing genomic drivers of these tumors, it remains unclear which genomic signatures are associated with recurrence, particularly following R0 resection.

Methods: Adrenocortical carcinoma patients treated with adrenalectomy in the Cancer Genome Atlas with recurrence data were identified using cBioPortal. Clinicopathologic variables, genomics, treatment patterns, and outcomes were retrospectively analyzed.

Results: Among 92 adrenocortical carcinoma patients, 84 had recurrence data, with 52% experiencing tumor recurrence. Age and sex were not significantly different between recurrent and nonrecurrent groups. Nonrecurrent patients had a significantly longer overall survival (54 months vs 35 months, P = .0036). Adjuvant radiation was administered similarly in both groups (25.0% vs 16.2%, P = .4164). There were no differences in capsular or venous invasion or median tumor size. Sixty-two patients had R0 resection and 40.3% (n = 25/62) recurred. Multivariate logistic regression in this cohort, when controlling for vascular invasion, venous invasion, and capsular invasion, revealed that the WNT (odds ratio 4.43 [1.09-18.0], P = .034), PI3K (odds ratio 7.80 [1.33-45.65], P = .023), and cell cycle (odds ratio 6.81 [1.43-32.30], P = .016) pathways were significantly associated with recurrence. Median time to recurrence was 7.9 months; early recurrence (<7.9 months) was associated with MYC pathway alterations (40.9% vs 9.1%, P = .0339).

Conclusion: This study identified genomic signatures in the PI3K, WNT, and cell cycle pathways associated with adrenocortical carcinoma recurrence, including in those who underwent R0 resection. Investigations regarding the utility of these signatures as a prognostic tool to dictate adjuvant therapies or targeted treatment are warranted.

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识别肾上腺皮质癌 R0 切除术后复发的基因组特征。

背景：肾上腺皮质癌（ACC肾上腺皮质癌（ACC）是一种罕见的侵袭性恶性肿瘤，治疗方案有限。尽管最近有进展揭示了这些肿瘤的基因组驱动因素，但目前仍不清楚哪些基因组特征与复发有关，尤其是在R0切除术后：方法：使用 cBioPortal 对癌症基因组图谱中接受肾上腺切除术治疗且有复发数据的肾上腺皮质癌患者进行鉴定。对临床病理变量、基因组学、治疗模式和结果进行了回顾性分析：在92名肾上腺皮质癌患者中，84人有复发数据，其中52%的患者肿瘤复发。复发组和非复发组的年龄和性别无明显差异。非复发患者的总生存期明显更长（54个月 vs 35个月，P = .0036）。两组患者的辅助放射治疗效果相似（25.0% vs 16.2%，P = .4164）。两组患者在囊肿或静脉侵犯以及肿瘤中位大小方面没有差异。62名患者进行了R0切除，40.3%（n = 25/62）的患者复发。该队列的多变量逻辑回归在控制血管侵犯、静脉侵犯和囊膜侵犯后发现，WNT（几率比 4.43 [1.09-18.0]，P = .034）、PI3K（几率比 7.80 [1.33-45.65]，P = .023）和细胞周期（几率比 6.81 [1.43-32.30]，P = .016）途径与复发显著相关。中位复发时间为 7.9 个月；早期复发（结论：中位复发时间为 7.9 个月）：本研究发现了与肾上腺皮质癌复发相关的 PI3K、WNT 和细胞周期通路基因组特征，包括接受 R0 切除术的患者。有必要对这些特征作为预后工具以决定辅助疗法或靶向治疗的实用性进行研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgery 医学-外科

CiteScore

5.40

自引率

5.30%

发文量

687

审稿时长

64 days

期刊介绍： For 66 years, Surgery has published practical, authoritative information about procedures, clinical advances, and major trends shaping general surgery. Each issue features original scientific contributions and clinical reports. Peer-reviewed articles cover topics in oncology, trauma, gastrointestinal, vascular, and transplantation surgery. The journal also publishes papers from the meetings of its sponsoring societies, the Society of University Surgeons, the Central Surgical Association, and the American Association of Endocrine Surgeons.