Impact of postoperative radiotherapy on the outcomes of resected adrenocortical carcinoma-a real-world, population-based study.

To assess the impact of postoperative radiotherapy on the outcomes of resected adrenocortical carcinoma in a real-world setting. The Surveillance, Epidemiology, and End Results Research Plus database was accessed, and patients with resected non-metastatic adrenocortical carcinoma diagnosed 2010–2015 were reviewed. Kaplan–Meier estimates and log-rank testing were used to examine the impact of postoperative radiotherapy on overall and cancer-specific survival. Multivariable Cox regression analysis was used to explore factors associated with overall and cancer-specific survival. A total of 294 patients were included in the final analysis, including 60 patients (20.4%) who received postoperative radiotherapy. Using Kaplan–Meier estimates, individuals who received postoperative radiotherapy have better overall survival (P = 0.002). Multivariable cox regression analysis showed that the following factors were associated with worse overall survival: older age (HR: 1.01; 95% CI: 1.00–1.03), male sex (HR for female sex versus male sex: 0.61; 95% CI: 0.43–0.85), and non-receipt of postoperative radiation therapy (HR: 2.29; 95% CI: 1.38–3.77). Systemic therapy was not associated with differences in overall survival (HR: 0.77; 95% CI: 0.54–1.10). Likewise, the following factors were associated with worse cancer-specific survival: male sex (HR for female sex versus male sex: 0.60; 95% CI: 0.41–0.88), non-receipt of postoperative radiation therapy (HR: 2.17; 95% CI: 1.27–3.70), and receipt of perioperative systemic therapy (HR: 0.67; 95% CI: 0.45–0.99). Postoperative radiotherapy following resection of adrenocortical carcinoma is associated with better overall and cancer-specific survival.