Prognosis and survival for adrenal gland cancer

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A prognosis is the doctor's best estimate of how cancer will affect you and how it will respond to treatment. Survival is the percentage of people with a disease who are alive at some point in time after their diagnosis. Prognosis and survival depend on many factors.

The doctor will look at certain aspects of the cancer as well as characteristics of the person. These are called prognostic factors. The doctor will also look at predictive factors, which influence how a cancer will respond to a certain treatment and how likely it is that the cancer will come back after treatment.

Prognostic and predictive factors are often discussed together. They both play a part in deciding on a prognosis and a treatment plan just for you. Only a doctor familiar with your medical history, the type and stage and size of the cancer and other features of the cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis and chances of survival.

The following are prognostic and predictive factors for adrenal gland cancer.

Stage

The stage of adrenal gland cancer is the most important factor in arriving at a prognosis.

A lower stage adrenal gland cancer has a better prognosis than a higher stage adrenal gland cancer.

If the cancer has spread into the major blood vessels, the prognosis is less favourable.

Heavier tumours have a poorer prognosis than smaller, lighter tumours.

Removed with surgery

Tumours that can be completely removed with surgery (called resectable tumours) have a more favourable prognosis. Tumours that can't be fully removed with surgery (called unresectable tumours) have a poorer prognosis.

Type of tumour

The prognosis changes depending on the type of adrenal gland tumour.

Tumours that start in the adrenal medulla (called pheochromocytomas) have a better prognosis than tumours that start outside the adrenal gland (called extra-adrenal pheochromocytomas, or paragangliomas).

Tumours that produce hormones (called functional tumours) have a more favourable prognosis than tumours that don't produce hormones (called non-functional tumours). The prognosis for functional tumours may be better because they cause symptoms associated with too much production of certain hormones and so may be diagnosed earlier.

Tumours that produce too much cortisol (called Cushing syndrome) have a less favourable prognosis than other functional tumours. This could be because Cushing syndrome often causes poor health.

Grade

Low-grade adrenocortical carcinomas (ACC) have a better prognosis than higher-grade ACCs.

Expert review and references

  • Shereen Ezzat, MD, FRCPC, FACP
  • Fassnacht M, Assie G, Baudin E, et al. Adrenocortical carcinomas and malignant phaeochromocytomas: ESMO–EURACAN Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology. 2020: 31(11):1476–1490.
  • Fassnacht M, Dekkers O, Else T, et al. European Society of Endocrinology clinical practice guidelines on the management of adrenocortical carcinoma in adults, in collaboration with the European Network for the Study of Adrenal Tumors. European Journal of Endocrinology. 2018: 79(4):G1–G46.
  • Jimenez C, Libutti SK, Landry CS, et al. Adrenal – neuroendocrine tumors. Amin, MB (ed.). AJCC Cancer Staging Manual. 8th ed. Chicago, IL: American College of Surgeons; 2017: 77:927–935.
  • O'Leary C, Birkhimer D. Endocrine malignancies. Yarbro CH, Wujcik D, Gobel B (eds.). Cancer Nursing: Principles and Practice. 8th ed. Burlington, MA: Jone & Bartlett Learning; 2018: Kindle version, chapter 52, https://read.amazon.ca/?asin=B01M6ZZEWT&ref_=kwl_kr_iv_rec_1.
  • Marcondes Lerario A, Mohan DR, Jolly S, Else T, Hammer GD. Adrenal tumours. DeVita VT Jr, Lawrence TS, Rosenberg S. eds. DeVita Hellman and Rosenberg's Cancer: Principles and Practice of Oncology. 12th ed. Philadelphia, PA: Wolters Kluwer; 2023: Kindle version, chapter 56, https://read.amazon.ca/?asin=B0BG3DPT4Q&language=en-CA.
  • PDQ Adult Treatment Editorial Board. Adrenocortical Carcinoma Treatment (PDQ®) – Health Professional Version. Bethesda, MD: National Cancer Institute; 2022. https://www.cancer.gov/.
  • Phan AT, Grogan RH, Rohren E, Perrier ND. Adrenal cortical carcinoma. Amin, MB (ed.). AJCC Cancer Staging Manual. 8th ed. Chicago, IL: American College of Surgeons; 2017: 76:919–926.

Survival statistics for adrenal gland cancer

Survival statistics for adrenal gland cancer are very general estimates. Survival is different for each stage and type of tumour.

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