Evidence map›Paper›PMID 41812315›Full record

Observational studyESMO open2026

Current clinical management and outcome of patients with adrenal cortical carcinoma (ACC) with rare histological subtypes-an ENSAT cohort study.

O Kimpel, D Cosentini, A Calabrese, A Jouinot, B Altieri, S Kircher, G Di Dalmazi, Y S Elhassan, D Vassiliadi, K Chrysoula and 19 more

Abstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in ESMO open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

29 authors.

O KimpelDivision of Endocrinology and Diabetes, Department of Medicine, University Hospital, University of Würzburg, Würzburg, Germany. Electronic address: Kimpel_o@ukw.de.
D CosentiniDepartment of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, ASST-Spedali Civili, Brescia, Italy.
A CalabreseInternal Medicine, San Luigi Gonzaga Hospital, Department of Clinical and Biological Sciences, University of Turin, Turin, Italy.
A JouinotUniversité Paris Cité, CNRS, Inserm, Institut Cochin, Paris, France; Department of Endocrinology and National Reference Center for Rare Adrenal Disorders, AP-HP, Hôpital Cochin, Paris, France.
B AltieriDivision of Endocrinology and Diabetes, Department of Medicine, University Hospital, University of Würzburg, Würzburg, Germany; Bavarian Cancer Research Center (BZKF), University Hospital, University of Würzburg, Würzburg, Germany.
S KircherInstitute of Pathology, University of Würzburg, Würzburg, Germany.
G Di DalmaziDivision of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy.
Y S ElhassanDepartment of Metabolism and Systems Science, College of Medicine and Health, University of Birmingham, Birmingham, UK; Department of Endocrinology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
D VassiliadiDepartment of Endocrinology, Diabetes Centre and European Reference Network on Rare Endocrine Conditions (Endo-ERN), Evangelismos Hospital, Athens, Greece.
K ChrysoulaDepartment of Endocrinology, Diabetes Centre and European Reference Network on Rare Endocrine Conditions (Endo-ERN), Evangelismos Hospital, Athens, Greece.
S PuglisiInternal Medicine, San Luigi Gonzaga Hospital, Department of Clinical and Biological Sciences, University of Turin, Turin, Italy.
K CosciaDivision of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy.
N V GallegoDepartment of Internal Medicine, Section of Endocrinology and Nutrition, Hospital Universitario de Cabueñes, Gijón, Spain.
P LoliEndocrinology, Clinica Polispecialistica San Carlo, Milan, Italy.
M BoudinaDepartment of Endocrinology, Theagenio Cancer Hospital, Thessaloniki, Greece.
M LaganaDepartment of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, ASST-Spedali Civili, Brescia, Italy.
V CremaschiDepartment of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, ASST-Spedali Civili, Brescia, Italy.
D PignatelliHospital S Joao and Faculty of Medicine, University of Porto, Porto, Portugal.
E RiosDepartment of Pathology, ULS São João, Porto, Portugal; Department of Oncology and Pathology, Faculty of Medicine, University of Porto, Porto, Portugal.
C A VillavicencioDivision of Endocrinology, Diabetes and Metabolism, Mayo Clinic, Rochester, USA.
T J McKenzieDivision of Endocrinology, Diabetes and Metabolism, Mayo Clinic, Rochester, USA.
N RayesDepartment of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital of Leipzig, Leipzig, Germany.
C L RonchiDepartment of Metabolism and Systems Science, College of Medicine and Health, University of Birmingham, Birmingham, UK; Department of Endocrinology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
I BancosDivision of Endocrinology, Diabetes and Metabolism, Mayo Clinic, Rochester, USA.
M TerzoloInternal Medicine, San Luigi Gonzaga Hospital, Department of Clinical and Biological Sciences, University of Turin, Turin, Italy.
A BerrutiDepartment of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, ASST-Spedali Civili, Brescia, Italy.
G AssiéUniversité Paris Cité, CNRS, Inserm, Institut Cochin, Paris, France; Department of Endocrinology and National Reference Center for Rare Adrenal Disorders, AP-HP, Hôpital Cochin, Paris, France.
M KroissDivision of Endocrinology and Diabetes, Department of Medicine, University Hospital, University of Würzburg, Würzburg, Germany; Department of Medicine IV, LMU University Hospital, LMU Munich, Munich, Germany.
M FassnachtDivision of Endocrinology and Diabetes, Department of Medicine, University Hospital, University of Würzburg, Würzburg, Germany; Bavarian Cancer Research Center (BZKF), University Hospital, University of Würzburg, Würzburg, Germany; Comprehensive Cancer Center Mainfranken and NCT WERA, University of Würzburg, Würzburg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn 2022, the World Health Organization (WHO) classified adrenal cortical carcinoma (ACC) into four subtypes: conventional, oncocytic, myxoid, and sarcomatoid. The differences in prognosis among these subtypes remain unclear. This European Network for the Study of Adrenal Tumours (ENSAT) multicentre study examines the differences not only in outcomes but also in the clinical management of patients with different ACC subtypes. PATIENTS AND

methodsPatient characteristics and survival data were retrospectively collected and analysed using Kaplan-Meier, multivariate Cox regression, and matched propensity score analyses (1 : 3 ratio) to compare recurrence-free survival (RFS) and overall survival (OS) for each subtype against conventional ACC. RFS was investigated only in patients after R0 resection, whereas OS was evaluated in the whole cohort. Matching was done for sex, age, and ENSAT tumour stage.

resultsThe study included 1098 conventional, 179 oncocytic, 28 myxoid, and 10 sarcomatoid ACCs. RFS (in 653 conventional, 127 oncocytic, 15 myxoid, and 6 sarcomatoid ACCs) and OS (in all patients) were significantly longer in oncocytic ACC compared with the other groups, which was confirmed by multivariate Cox regression analyses {hazard ratio (HR) for RFS using conventional ACC as reference: oncocytic 0.47 [95% confidence interval (CI) 0.34-0.66], myxoid 0.92 (0.49-1.71), and sarcomatoid 0.83 (0.13-2.13) and for OS: oncocytic 0.37 (0.22-0.61), myxoid 1.02 (0.50-2.1), and sarcomatoid 0.82 (0.11-5.94)}. Similar results were seen after propensity score matching. RFS and OS were significantly longer in oncocytic ACC compared with the matched conventional ACC (RFS HR 0.41, 95% CI 0.29-0.55, P < 0.001; OS HR 0.35, 95% CI 0.24-0.52, P < 0.001).In metastatic oncocytic ACC, mitotane was similarly effective as in conventional tumours, but platinum-based chemotherapy seemed to result in longer progression-free survival.

conclusionStage-adjusted outcome in oncocytic ACC is better than in other subtypes.

Indexed as

Adrenal Cortex NeoplasmsAdrenocortical CarcinomaAgedCohort StudiesFemaleHumansMaleMiddle AgedPrognosisRetrospective Studiesadrenal cancerhistological subtypesprognosis

Identifiers

PMID41812315
PMCPMC12995484

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