1187MO - Does the ENDOCAN-COMETE network improves the survival of adrenocortical carcinomas in France?

Background

Adrenocortical carcinoma (ACC) belongs to the family of rare cancers (annual rate of 0.72-1.3 cases/million people). The French national network « ENDOCAN-COMETE », was set up in 2009 to structure care and research on ACC patients across the country. The aim of this study was to look for the survival impact of this national network organization.

Methods

ACC diagnosed between 2010 and 2017 were, first, identified from 13 cancer registries of the French network FRANCIM covering 18% of the French population. This population was described in term of characteristics, systemic managements and treatment delays. Secondly, ACC patients identified by FRANCIM were categorized as 1/ referred to one of the 11 centres of the French ENDOCAN-COMETE network at diagnosis (ACC-R) or, 2/ ACC patients lately or not referred (ACC-nR). The survival rate at 2, 3 and 5 years (2-yrs OS, 3yrs OS and 5yrs-OS) were compared, according to ENSAT stage classified as localized (stage I-II) or advanced (stage III-IV).

Results

Between 2010 and 2017, 134 ACC were diagnosed in this population (mean estimated incidence of 0.14/100000 pers-yrs): 12 (9%) were stage I, 44 (33%) stage II, 17 (13%) stage III and 48 (36%) stage IV (13 patients ENSAT stage was unknown). Among them, 124 patients were analyzed (10 patients were excluded). Eighty-seven out 124 patients (70%) were referred to an ENDOCAN-COMETE network at diagnosis (ACC-R). Mean age at diagnosis was 51.5 yrs (ACC-R) vs. 58.6 (ACC-nR). Overall Survival (OS) rates of localized ACC (ENSAT stage I-II) was significantly higher in ACC-R compared to ACC-nR : 2-yrs OS was 94% vs 65%, 3-yrs OS was 90% vs 65% and 5-yrs OS was 79% vs 51%, p=0.025 (mean OS : 6.6 vs 3.15 yrs). OS rates were similar in advanced ACC (ENSAT stage III-IV) between ACC-R vs ACC-nR. In localized ACC: 39% were ACC-R vs. 54% ACC-nR. By comparing localized ACC-R vs localized ACC-nR, we found that complete resection was found in 76% vs 68%, Weiss score median was 5 vs 5, median Ki67 was 6% vs 15%, presence of endocrine syndrome was 47% vs 35% and age was 47 vs 58 yrs, respectively. Moreover 81% of ACC-R patients received mitotane treatment vs 65% of ACC-nR.

Conclusions

Our study shows a better survival of stage I-II ACC patients treated in the French ENDOCAN COMETE network.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.