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Purpose
To evaluate the clinical characteristics and prognostic factors in patients with adrenocortical carcinoma (ACC) in South Korea.
Methods
A nationwide, registry-based survey was conducted to identify pathologically proven ACC at 25 tertiary care centers in South Korea between 2000 and 2014. Cox proportional hazard model and log-rank test were adopted for survival analysis.
Results
Two hundred four patients with ACC were identified, with a median follow-up duration of 20 months (IQR 5–52 months). The median age at diagnosis was 51.5 years (IQR 40–65.8 years), and ACC was prevalent in women (n = 110, 53.9%). Abdominal pain was the most common clinical symptom (n = 70, 40.2%), and ENSAT stage 2 was most common (n = 62, 30.4%) at the time of diagnosis. One hundred sixty-nine patients underwent operation, while 17 were treated with other modalities. The remission rate was 48%, and median recurrence-free survival time was 46 months. Estimated 5-year recurrence-free rate was 44.7%. There were more women, large tumor, atypical mitosis, venous invasion, and higher mitotic count in cancer recurrence group. Estimated 5-year overall survival and disease-specific survival rates were 64.5 and 70.6%, respectively. Higher ENSAT stage and advanced pathologic characteristics were risk factors for all-cause mortality of ACC. Large tumor size and cortisol-secreting tumor were additional risk factors for ACC-specific death.
Conclusions
We report the first epidemiologic study regarding ACC in an Asian population. ENSAT stage 4; lymph node involvement; non-operative group; and invasion of vein, sinusoid, or capsule were associated with an increased risk for all-cause mortality.
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Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Lægerne på Ellemarksvej, Køge, Denmark
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Department of Cardiology, Herlev-Gentofte University Hospital, Herlev, Denmark
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Novo Nordisk A/S, Søborg, Denmark
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Lund University Diabetes Centre, Skåne University Hospital, Malmø, Sweden
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Finnish Institute for Molecular Medicine (FIMM), Helsinki University, Helsinki, Finland
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Department of Biomedical Sciences, NNF Center for Basic Metabolic Research, The Panum Institute, Copenhagen, Denmark
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Department of Endocrinology, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
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Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Introduction
In healthy carriers of the T allele of the transcription factor 7-like 2 (TCF7L2), fasting plasma glucagon concentrations are lower compared with those with the C allele. We hypothesised that presence of the T allele is associated with a diminished glucagon response during hypoglycaemia and a higher frequency of severe hypoglycaemia (SH) in type 1 diabetes (T1DM).
Material and methods
This is a post hoc study of an earlier prospective observational study of SH and four mechanistic studies of physiological responses to hypoglycaemia. 269 patients with T1DM were followed in a one-year observational study. A log-linear negative binomial model was applied with events of SH as dependent variable and TCF7L2 alleles as explanatory variable. In four experimental studies including 65 people, TCF7L2 genotyping was done and plasma glucagon concentration during experimental hypoglycaemia was determined.
Results
Incidences of SH were TT 0.54, TC 0.98 and CC 1.01 episodes per patient-year with no significant difference between groups. During experimental hypoglycaemia, the TCF7L2 polymorphism did not influence glucagon secretion.
Discussion
Patients with T1DM carrying the T allele of the TCF7L2 polymorphism do not exhibit diminished glucagon response during hypoglycaemia and are not at increased risk of severe hypoglycaemia compared with carriers of the C allele.
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that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported. Funding This work was supported by Cancer Research UK, as they supported the start-up of the Cancer Epidemiology Group at King
Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
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Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
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Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands
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NC Jager KJ . Sex and gender disparities in the epidemiology and outcomes of chronic kidney disease . Nature Reviews: Nephrology 2018 14 151 – 164 . ( https://doi.org/10.1038/nrneph.2017.181 ) 6 Cho MH Jung KJ Jang HS Kim JI Park KM
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Appel K Grabe HJ . Diagnosed thyroid disorders are associated with depression and anxiety . Social Psychiatry and Psychiatric Epidemiology 2015 50 1417 – 1425 . ( https://doi.org/10.1007/s00127-015-1043-0 ) 8 Gulseren S Gulseren L Hekimsoy
INSERM U1018, Université Paris Sud, Centre for Research in Epidemiology and Population Health, Hôpital Paul Brousse, Bât 15/16, 16 Avenue Paul Vaillant Couturier, 94807 Paris, Villejuif Cedex, France
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– 498 . ( doi:10.1002/ana.21509 ). 34 Brayne C . The elephant in the room – healthy brains in later life, epidemiology and public health . Nature Reviews. Neuroscience 2007 8 233 – 239 . ( doi:10.1038/nrn2091 ). 35 Hachinski V . Shifts in
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Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, Varese, Italy
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Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, Varese, Italy
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Donato KA Fruchart J-C James WPT Loria CM Smith SC Jr. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood
Department of Epidemiology St. Luke’s International University Graduate School of Public Health, Tokyo, Japan
Fujita Health University Toyoake, Japan
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Department of Epidemiology St. Luke’s International University Graduate School of Public Health, Tokyo, Japan
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Kasper JS Giovannucci E . A meta-analysis of diabetes mellitus and the risk of prostate cancer . Cancer Epidemiology, Biomarkers and Prevention 2006 15 2056 – 2062 . ( https://doi.org/10.1158/1055-9965.EPI-06-0410 ) 34 Atalay HA Akarsu M Canat L
Danish Diabetes Academy, Odense University Hospital, Odense, Denmark
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Department of Public Health, Research Unit of Epidemiology, Aarhus University, Aarhus, Denmark
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Department of Public Health, Research Unit of Epidemiology, Aarhus University, Aarhus, Denmark
Steno Diabetes Center Aarhus, Aarhus, Denmark
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Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
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National Institute of Public Health, University of Southern Denmark, Odense, Denmark
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Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
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KORA Study Centre, University Hospital of Augsburg, Augsburg, Augsburg, Germany
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German Centre for Cardiovascular Research (DZHK), Partner site Munich Heart Alliance, Munich, Germany
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German Heart Centre Munich, Technical University of Munich, Munich, Germany
Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany
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German Centre for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
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. Assessing obesity: classification and epidemiology . British Medical Bulletin 1997 53 238 – 252 . ( https://doi.org/10.1093/oxfordjournals.bmb.a011611 ) 27 Plebani M . Quality indicators to detect pre-analytical errors in laboratory testing . Clinical
