Evidence map›Paper›PMID 26775162›Full record

ArticleJournal of the American College of Surgeons2016

Outcomes of Adjuvant Mitotane after Resection of Adrenocortical Carcinoma: A 13-Institution Study by the US Adrenocortical Carcinoma Group.

Lauren M Postlewait, Cecilia G Ethun, Thuy B Tran, Jason D Prescott, Timothy M Pawlik, Tracy S Wang, Jason Glenn, Ioannis Hatzaras, Rivfka Shenoy, John E Phay and 18 more

Erratum issuedAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American College of Surgeons, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 40 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
40citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

40 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Trial
  5. Article
  6. Article
  7. Systemic Management of Advanced Adrenocortical Carcinoma.Current treatment options in oncology · 2024
    Review
  8. Article
  9. Article
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  12. Article
  13. Review
  14. Article
  15. Article
  16. Article
  17. Article
  18. Article
  19. Article
  20. The Challenging Pharmacokinetics of Mitotane: An Old Drug in Need of New Packaging.European journal of drug metabolism and pharmacokinetics · 2021
    Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

28 authors.

Lauren M PostlewaitDivision of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA.
Cecilia G EthunDivision of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA.
Thuy B TranDepartment of Surgery, Stanford University School of Medicine, Stanford, CA.
Jason D PrescottDepartment of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD.
Timothy M PawlikDepartment of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD.
Tracy S WangDepartment of Surgery, Medical College of Wisconsin, Milwaukee, WI.
Jason GlennDepartment of Surgery, Medical College of Wisconsin, Milwaukee, WI.
Ioannis HatzarasDepartment of Surgery, New York University School of Medicine, New York, NY.
Rivfka ShenoyDepartment of Surgery, New York University School of Medicine, New York, NY.
John E PhayDepartment of Surgery, The Ohio State University, Columbus, OH.
Kara KeplingerDepartment of Surgery, The Ohio State University, Columbus, OH.
Ryan C FieldsDepartment of Surgery, Washington University School of Medicine, St Louis, MO.
Linda X JinDepartment of Surgery, Washington University School of Medicine, St Louis, MO.
Sharon M WeberDepartment of General Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI.
Ahmed SalemDepartment of General Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI.
Jason K SicklickDepartment of Surgery, University of California San Diego, San Diego, CA.
Shady GadDepartment of Surgery, University of California San Diego, San Diego, CA.
Adam C YoppDepartment of Surgery, University of Texas Southwestern Medical Center, Dallas, TX.
John C MansourDepartment of Surgery, University of Texas Southwestern Medical Center, Dallas, TX.
Quan-Yang DuhDepartment of Surgery, University of California San Francisco, San Francisco, CA.
Natalie SeiserDepartment of Surgery, University of California San Francisco, San Francisco, CA.
Carmen C SolorzanoDepartment of Surgery, Vanderbilt University, Nashville, TN.
Colleen M KiernanDepartment of Surgery, Vanderbilt University, Nashville, TN.
Konstantinos I VotanopoulosDepartment of Surgery, Wake Forest School of Medicine, Winston-Salem, NC.
Edward A LevineDepartment of Surgery, Wake Forest School of Medicine, Winston-Salem, NC.
Charles A StaleyDivision of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA.
George A PoultsidesDepartment of Surgery, Stanford University School of Medicine, Stanford, CA.
Shishir K MaithelDivision of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA. Electronic address: smaithe@emory.edu.

Funding

Novel Allosteric Kinase Inhibitors Target Imatinib-Resistant GISTK08CA168999 · NCI · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI SICKLICK, JASON KEITH · 2014 to 2018
$888k
Defining the Germline Genomic Landscape of a Novel GIST Multi-tumor SyndromeR21CA192072 · NCI · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI SICKLICK, JASON KEITH · 2016 to 2017
$399k
NCI NIH HHS K08 CA168999NCI NIH HHS R21 CA192072
6 · The paper itself

Abstract

backgroundCurrent treatment guidelines recommend adjuvant mitotane after resection of adrenocortical carcinoma with high-risk features (eg, tumor rupture, positive margins, positive lymph nodes, high grade, elevated mitotic index, and advanced stage). Limited data exist on the outcomes associated with these practice guidelines. STUDY

designPatients who underwent resection of adrenocortical carcinoma from 1993 to 2014 at the 13 academic institutions of the US Adrenocortical Carcinoma Group were included. Factors associated with mitotane administration were determined. Primary end points were recurrence-free survival (RFS) and overall survival (OS).

resultsOf 207 patients, 88 (43%) received adjuvant mitotane. Receipt of mitotane was associated with hormonal secretion (58% vs 32%; p = 0.001), advanced TNM stage (stage IV: 42% vs 23%; p = 0.021), adjuvant chemotherapy (37% vs 5%; p < 0.001), and adjuvant radiation (17% vs 5%; p = 0.01), but was not associated with tumor rupture, margin status, or N-stage. Median follow-up was 44 months. Adjuvant mitotane was associated with decreased RFS (10.0 vs 27.9 months; p = 0.007) and OS (31.7 vs 58.9 months; p = 0.006). On multivariable analysis, mitotane was not independently associated with RFS or OS, and margin status, advanced TNM stage, and receipt of chemotherapy were associated with survival. After excluding all patients who received chemotherapy, adjuvant mitotane remained associated with decreased RFS and similar OS; multivariable analyses again showed no association with recurrence or survival. Stage-specific analyses in both cohorts revealed no association between adjuvant mitotane and improved RFS or OS.

conclusionsWhen accounting for stage and adverse tumor and treatment-related factors, adjuvant mitotane after resection of adrenocortical carcinoma is not associated with improved RFS or OS. Current guidelines should be revisited and prospective trials are needed.

Indexed as

Adrenal Cortex NeoplasmsAdrenalectomyAdrenocortical CarcinomaAdultAgedAntineoplastic Agents, HormonalChemotherapy, AdjuvantDisease-Free SurvivalFemaleHumansMaleMiddle AgedMitotaneRetrospective StudiesTreatment OutcomeUnited StatesAntineoplastic Agents, HormonalMitotane

Identifiers

PMID26775162
PMCPMC4957938

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.