title: Outcomes of adrenal cortical carcinoma in the United States.
abstract: BACKGROUND
  Improvements in the sensitivity of radiographic imaging have lead to an increase in the number of adrenal masses diagnosed. The purpose of this study is to determine if technologic advancements have resulted in the diagnosis of earlier-staged adrenal cortical cancer (ACC) and to determine if the survival of patients with ACC has improved over the past 15 years.
  
  
  METHODS
  Patients with ACC were identified in the Surveillance, Epidemiology, and End Results database between 1988 and 2002. Changes in demographics, stage, size, and treatment were analyzed by standard statistical testing.
  
  
  RESULTS
  We identified 602 patients with a mean age of 53 years and an average tumor size of 11.8 cm. Two hundred thirty-eight (39.5%) patients presented with localized disease (stages I and II), and 311 (52%) patients presented with advanced disease (stages III and IV). The comparison of smaller lesions and number of patients were 5 to 6 cm in 24 (4%) patients, 4 to 5 cm in 27 (4.5%) patients, and <4 cm in 19 (3.1%) patients. Patients with masses less than 5 cm were statistically more likely to have localized disease (P <. 001). Age (P = .10), tumor size (P = .85), tumor stage (P = .45), and 5-year survival (P = .5) did not change over the 15-year study.
  
  
  CONCLUSIONS
  Over the 15-year study, patients with ACC were not diagnosed at an earlier stage or with tumors smaller, and survival did not improve.
authors.affiliation: Division of Gastrointestinal and Minimally Invasive Surgery, Carolinas Medical Center, Charlotte, NC 28203, USA.
authors.forename: B Lauren
authors.initials: BL
authors.lastname: Paton
authors.forename: Yuri W
authors.initials: YW
authors.lastname: Novitsky
authors.forename: Marc
authors.initials: M
authors.lastname: Zerey
authors.forename: Andrew G
authors.initials: AG
authors.lastname: Harrell
authors.forename: H James
authors.initials: HJ
authors.lastname: Norton
authors.forename: Horatio
authors.initials: H
authors.lastname: Asbun
authors.forename: Kent W
authors.initials: KW
authors.lastname: Kercher
authors.forename: B Todd
authors.initials: BT
authors.lastname: Heniford
mesh_terms: D000306:Adrenal Cortex Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology*; D000311:Adrenal Glands / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D018426:SEER Program / Q000706:statistics & numerical data*; D015996:Survival Rate; D014481:United States / Q000453:epidemiology