Inflammation-based score in pediatric adrenocortical carcinoma

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.

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Publication Details

Journal
Endocrine Related Cancer
Published
2025-03-18
DOI
https://doi.org/10.1530/erc-24-0244
Citations
1
Primary Topic
Adrenal and Paraganglionic Tumors
Type
article
Field-Weighted Citation Impact
2.01
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article

Inflammation-based score in pediatric adrenocortical carcinoma

Bilgehan Yalçın, Martin Faßnacht, Jagdish Prasad Meena, Max M. van Noesel et al.
1 citations
Endocrine Related Cancer
Adrenal and Paraganglionic Tumors
2.01
article

Inflammation-based score in pediatric adrenocortical carcinoma

Bilgehan Yalçın, Martin Faßnacht, Jagdish Prasad Meena, Max M. van Noesel, Jaydira Del Rivero, Steffen Fuchs, Gerdi Tuli, Jessica Munarin, Mouna Mezoued, Heidi Frey, Sonir Roberto Rauber Antonini, Irene Schmid, N. Köse, Soraya Puglisi, Thomas Perwein, Ronald R. de Krijger, Maria Riedmeier, Simon H. S. Pearce, Jan Idkowiak, Tezer Kutluk, Dominika Januś, Christoph Härtel, Verena Wiegering, Nerea Domínguez‐Pinilla, Justyna Walenciak, G Canali, Carl Friedrich Classen, Paul G. Schlegel, Ngoc Bui
article en
1 citations

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.

Endocrine Related CancerVol. 32(5)
Jagiellonian University (PL), Birmingham City University (GB), National Institutes of Health (US), Universidade de São Paulo (BR), University of Algiers Benyoucef Benkhedda (DZ), Medical University of Graz (AT), University Medical Center Utrecht (NL), Research Institute Hospital 12 de Octubre (ES), Comprehensive Cancer Center Mainfranken (DE), German Cancer Society (DE), Hospital Erasto Gaertner (BR), Medical University of Lodz (PL), Universitätsklinikum Würzburg (DE), Princess Máxima Center (NL), German Centre for Cardiovascular Research (DE), Ospedale Regina Margherita (IT), Instituto de Oncologia do Paraná (BR), Vietnam National Children's Hospital (VN), Berlin Institute of Health at Charité - Universitätsmedizin Berlin (DE), National Cancer Institute (US), Center for Cancer Research (US), Birmingham Women’s and Children’s NHS Foundation Trust (GB), Ospedale San Luigi Gonzaga (IT), NIHR Birmingham Biomedical Research Centre (GB), University of Rostock (DE), University of Turin (IT), All India Institute of Medical Sciences (IN), Hacettepe University (TR), Charité - Universitätsmedizin Berlin (DE), University of Birmingham (GB), Ludwig-Maximilians-Universität München (DE), Newcastle University (GB)
Good health and well-being
Openalex Percentile: Top 18%
Adrenal and Paraganglionic Tumors
2.01
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