Prognosis and survival for adrenal gland cancer
If you have adrenal gland cancer, you may have questions about your prognosis. A prognosis is the doctor’s best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many factors. Only a doctor familiar with your medical history, the type, stage and size of the cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis.
A prognostic factor is an aspect of the cancer or a characteristic of the person (such as age) that the doctor will consider when making a prognosis. A predictive factor influences how a cancer will respond to a certain treatment. Prognostic and predictive factors are often discussed together. They both play a part in deciding on a treatment plan and a prognosis.
The following are prognostic and predictive factors for adrenal gland cancer.
The stage of adrenal gland cancer is the most important factor in determining a prognosis. A lower stage adrenal gland cancer has a better prognosis than a higher stage adrenal gland cancer. If the cancer has spread into the major blood vessels, the prognosis is less favourable. Heavier tumours have a poorer prognosis than smaller, lighter tumours.
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Tumours that can be completely removed with surgery (resectable) have a more favourable prognosis. Tumours that cannot be fully removed with surgery (unresectable) have a poorer prognosis.
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The prognosis changes depending on the type of adrenal gland tumour.
Tumours that start in the adrenal medulla (pheochromocytomas) have a better prognosis than tumours that start outside the adrenal gland (extra-adrenal pheochromocytomas, or paragangliomas).
Tumours that produce hormones (functional tumours) have a more favourable prognosis than tumours that do not produce hormones (non-functional tumours). The prognosis may be better because these tumours cause symptoms associated with too much production of certain hormones and so may be diagnosed earlier.
Tumours that produce too much cortisol (Cushing syndrome) have a less favourable prognosis than other functional tumours. This could be because Cushing syndrome often causes poor health.
Low-grade adrenocortical carcinomas (ACC) have a better prognosis than high-grade ACCs.
Younger people may have a better prognosis than people diagnosed at an older age.
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American Joint Committee on Cancer. AJCC Cancer Staging Handbook. 7th ed. Chicago: Springer; 2010.
Lirov R, Else T, Lerario AM, Hammer GD . Adrenal tumors. DeVita VT Jr, Lawrence TS, Rosenberg SA. Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015: 84:1195-1204.
National Cancer Institute. Pheochromocytoma and Paraganglioma Treatment (PDQ®) for Health Professionals. 2015: https://www.cancer.gov/types/pheochromocytoma/hp/pheochromocytoma-treatment-pdq.
National Cancer Institute. Adrenocortical Carcinoma Treatment (PDQ®) for Health Professionals. 2015: https://www.cancer.gov/types/adrenocortical/hp/adrenocortical-treatment-pdq.