Inflammation-based score in pediatric adrenocortical carcinoma
Year: 2025
Type: article
Study design: Observational Study
Abstract: Inflammation-based scores have been demonstrated to be independent prognostic factors in predicting outcomes in adult adrenocortical carcinoma (ACC). We aimed to investigate the prognostic role of these scores in pediatric adrenocortical carcinoma (pACC) patients. An international multicenter analysis was conducted on a pediatric cohort from 21 ACC centers. Pretreatment inflammation-based scoring parameters, including neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (dNLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR) and serum albumin, as well as clinical parameters, were analyzed. The primary endpoint was 10-year overall survival (OS). One hundred twenty-nine pediatric patients (50.4% females, mean age 87 months) across all tumor stages with a median follow-up of 36 months were included. 107/108 patients underwent primary surgery, and 62/106 received systemic treatment at the time of diagnosis. Of 102 patients, 27 died from disease. In the univariable analysis, NLR ≥5 (HR 8.0, 95% CI 3.4-19.1), MLR ≥0.28 (HR 4.2, 95% CI 1.7-10.4), PLR ≥190 (HR 4.5, 95% CI 2.0-10.4) and dNLR ≥1.44 (HR 5.9, 95% CI 2.3-15.5), as well as clinical parameters age ≥4 years (HR 5.5, 95% CI 1.9-15.8), tumor stage IV (HR 5.7, 95% CI 2.7-11.9) and incomplete resection status (HR 8.0, 95% CI 3.6-17.7) were significantly associated with reduced 10-year OS. After multivariable adjustment, only tumor stage IV (HR 336.7, 95% CI 5.8-19,518.1) and MLR ≥0.28 (HR 247.1, 95% CI = 3.1-19,907.5) were significantly associated with an unfavorable outcome. Inflammation-based scores tend to have prognostic value in pACC and could serve as prognostic tools after further validation in future studies with sufficient case numbers.
Source: Endocrine Related Cancer
DOI: 10.1530/erc-24-0244
Authors: Maria Riedmeier, Jan Idkowiak, Heidi Frey, Sonir R R Antonini, Gabriela Fernandes Luiz Canali, Carl Friedrich Classen, Nerea Domínguez-Pinilla, Martin Fassnacht, Steffen Fuchs, Christoph Härtel, Dominika Janús, Ronald de Krijger, Tezer Kutluk, Ngoc Lan Bui, Jagdish Prasad Meena, Mouna Mezoued, Jessica Munarin, Max M van Noesel, Nihal Özdemir Köse, Simon H Pearce, Thomas Perwein, Soraya Puglisi, Jaydira Del Rivero, Paul G Schlegel, Irene Schmid, Gerdi Tuli, Justyna Walenciak, Bilgehan Yalcin, Verena Wiegering
Institutions: University of Würzburg, Universitätsklinikum Würzburg, Birmingham Women’s and Children’s NHS Foundation Trust, University of Birmingham, Universidade de São Paulo, Universitätsmedizin Rostock, University of Rostock, Research Institute Hospital 12 de Octubre, Hospital Universitario 12 De Octubre, Comprehensive Cancer Center Mainfranken, Charité - Universitätsmedizin Berlin, German Cancer Research Center, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Deutsches Konsortium für Translationale Krebsforschung, Jagiellonian University, University Medical Center Utrecht, Princess Máxima Center, Hacettepe University, Vietnam National Children's Hospital, All India Institute of Medical Sciences, University of Algiers Benyoucef Benkhedda, Ospedale Regina Margherita, University of Turin, Newcastle University, Medical University of Graz, Ospedale San Luigi Gonzaga, National Institutes of Health, National Cancer Institute, National Cancer Institute, Center for Cancer Research, LMU Klinikum, Ludwig-Maximilians-Universität München, Medical University of Lodz
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W4408569149