Medizinische Universität Graz - Research portal
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SHR Neuro Cancer Cardio Lipid Metab Microb
Riedmeier, M; Frey, H; Antonini, SRR; Canali, GFL; Classen, CF; Domínguez-Pinilla, N; Fassnacht, M; Fuchs, S; Härtel, C; Idkowiak, J; Januś, D; de, Krijger, R; Kutluk, T; Bui, NL; Meena, JP; Mezoued, M; Munarin, J; van, Noesel, MM; Köse, NÖ; Pearce, SH; Perwein, T; Puglisi, S; Del, Rivero, J; Schlegel, PG; Schmid, I; Tuli, G; Walenciak, J; Yalcin, B; Wiegering, V.
Inflammation-based score in pediatric adrenocortical carcinoma.
Endocr Relat Cancer. 2025;
Doi: 10.1530/ERC-24-0244
[OPEN ACCESS]
PubMed
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- Co-authors Med Uni Graz
- Perwein Thomas
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- Abstract:
- Inflammation-based scores have been demonstrated to be independent prognostic factors in predicting outcomes in adult ACC. We aimed to investigate the prognostic role of these scores in 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. Primary endpoint was 10-year overall survival (OS). 129 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 = 5.8-19518.1) and MLR ≥ 0.28 (HR 247.1, 95% CI=3.1-19907.5) 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 number.