Development and Interpretation of a Novel Nomogram for the Prognosis of Adult Metastatic Adrenocortical Carcinoma: A Retrospective Cohort Study

Purpose: To predict the prognosis of patients with metastatic adrenocortical carcinoma (mACC) and improve overall survival, we developed and validated a nomogram for predicting survival outcomes. Methods Adult metastatic patients were selected between 2000 and 2019 from Surveillance, Epidemiology, and End Results Program (SEER). Independent risk factors were identified by univariate and multivariate cox regression analysis. Overall survival was calculated by Kaplan–Meier. C-index, the area under the receiver operating characteristics curve (AUC) and calibration curve were employed to validate the model. Results A total of 336 mACC patients were included and randomly divided into training cohort (N = 235) and validation cohort (N = 101). The nomogram, based on independent chemotherapy and surgery predictors, exhibited favorable discrimination with C-index values of 0.704 and 0.702 for the training and validation cohorts, respectively. The AUC and calibration curve indicated favorable performance in both cohorts. Conclusion We constructed and validated a novel prognostic nomogram for mACC patients by incorporating chemotherapy and surgery, which assist clinical doctors to choose optimal clinical decision and improve the overall survival of mACC patients. In the future, chemotherapy combined with surgery or other may be recommended as first-line therapy for mACC patients.