1187MO Does the ENDOCAN-COMETE network improves the survival of adrenocortical carcinomas in France?
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Abstract Book of the ESMO Congress 2023, ESMO Congress 2023, 2023-10-20, Madrid. 2023-10, vol. 34, n° Supplement 2, p. S703-S703
Résumé en anglais
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 ...Lire la suite >
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%, p¼0.025 (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.< Réduire
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