TY  - JOUR
A1  - Riedmeier, Maria
A1  - Decarolis, Boris
A1  - Haubitz, Imme
A1  - Müller, Sophie
A1  - Uttinger, Konstantin
A1  - Börner, Kevin
A1  - Reibetanz, Joachim
A1  - Wiegering, Armin
A1  - Härtel, Christoph
A1  - Schlegel, Paul-Gerhardt
A1  - Fassnacht, Martin
A1  - Wiegering, Verena
T1  - Adrenocortical carcinoma in childhood: a systematic review
T2  - Cancers
N2  - Adrenocortical tumors are rare in children. This systematic review summarizes the published evidence on pediatric adrenocortical carcinoma (ACC) to provide a basis for a better understanding of the disease, investigate new molecular biomarkers and therapeutic targets, and define which patients may benefit from a more aggressive therapeutic approach. We included 137 studies with 3680 ACC patients (~65% female) in our analysis. We found no randomized controlled trials, so this review mainly reflects retrospective data. Due to a specific mutation in the TP53 gene in ~80% of Brazilian patients, that cohort was analyzed separately from series from other countries. Hormone analysis was described in 2569 of the 2874 patients (89%). Most patients were diagnosed with localized disease, whereas 23% had metastasis at primary diagnosis. Only 72% of the patients achieved complete resection. In 334 children (23%), recurrent disease was reported: 81% — local recurrence, 19% (n = 65) — distant metastases at relapse. Patients < 4 years old had a different distribution of tumor stages and hormone activity and better overall survival (p < 0.001). Although therapeutic approaches are typically multimodal, no consensus is available on effective standard treatments for advanced ACC. Thus, knowledge regarding pediatric ACC is still scarce and international prospective studies are needed to implement standardized clinical stratifications and risk-adapted therapeutic strategies.
KW  - pediatric adrenocortical cancer
KW  - pediatric adrenocortical adenoma
KW  - pediatric adrenocortical tumor
KW  - prognostic factors
KW  - therapy
Y1  - 2021
UR  - https://opus.bibliothek.uni-wuerzburg.de/frontdoor/index/index/docId/24850
UR  - https://nbn-resolving.org/urn:nbn:de:bvb:20-opus-248507
SN  - 2072-6694
VL  - 13
IS  - 21
ER  -