Evidence map›Paper›PMID 27590329›Full record

ArticleAnnals of surgical oncology2016

Lymphadenectomy for Adrenocortical Carcinoma: Is There a Therapeutic Benefit?

Jon M Gerry, Thuy B Tran, Lauren M Postlewait, Shishir K Maithel, Jason D Prescott, Tracy S Wang, Jason A Glenn, John E Phay, Kara Keplinger, Ryan C Fields and 18 more

Open access · greenAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of surgical oncology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed
6.0field-weighted citation impact, top 4% of its field
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

18 citing papers in PubMed, 52 citations in OpenAlex.

  1. Article
  2. Article
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  4. Review
  5. Article
  6. Review
  7. Observational
  8. Review
  9. Article
  10. [Surgery of adrenal diseases].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2020
    Article
  11. Article
  12. Management of Adrenocortical Carcinoma.Current oncology reports · 2019
    Review
  13. [Resection strategies for adrenocortical carcinoma].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2019
    Review
  14. Article
  15. [Surgical strategies for non-metastatic adrenocortical carcinoma].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2018
    Review
  16. The impact of patient-, disease-, and treatment-related factors on survival in patients with adrenocortical carcinoma.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2018
    Article
  17. Article
  18. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

28 authors at 13 institutions in 1 country.

Jon M GerryDepartment of Surgery, Stanford University, Stanford, CA, USA.
Thuy B TranDepartment of Surgery, Stanford University, Stanford, CA, USA.
Lauren M PostlewaitDepartment of Surgery, Emory University, Atlanta, GA, USA.
Shishir K MaithelDepartment of Surgery, Emory University, Atlanta, GA, USA.
Jason D PrescottDepartment of Surgery, The Johns Hopkins University, Baltimore, MD, USA.
Tracy S WangDepartment of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA.
Jason A GlennDepartment of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA.
John E PhayDepartment of Surgery, The Ohio State University, Columbus, OH, USA.
Kara KeplingerDepartment of Surgery, The Ohio State University, Columbus, OH, USA.
Ryan C FieldsDepartment of Surgery, Washington University, St. Louis, MO, USA.
Linda X JinDepartment of Surgery, Washington University, St. Louis, MO, USA.
Sharon M WeberDepartment of Surgery, University of Wisconsin, Madison, WI, USA.
Ahmed SalemDepartment of Surgery, University of Wisconsin, Madison, WI, USA.
Jason K SicklickDepartment of Surgery, University of California San Diego, San Diego, CA, USA.
Shady GadDepartment of Surgery, University of California San Diego, San Diego, CA, USA.
Adam C YoppDepartment of Surgery, University of Texas Southwestern, Dallas, TX, USA.
John C MansourDepartment of Surgery, University of Texas Southwestern, Dallas, TX, USA.
Quan-Yang DuhDepartment of Surgery, University of California San Francisco, San Francisco, CA, USA.
Natalie SeiserDepartment of Surgery, University of California San Francisco, San Francisco, CA, USA.
Carmen C SolorzanoDepartment of Surgery, Vanderbilt University, Nashville, TN, USA.
Colleen M KiernanDepartment of Surgery, Vanderbilt University, Nashville, TN, USA.
Konstantinos I VotanopoulosDepartment of Surgery, Wake Forest University, Winston Salem, NC, USA.
Edward A LevineDepartment of Surgery, Wake Forest University, Winston Salem, NC, USA.
Ioannis HatzarasDepartment of Surgery, New York University, New York, NY, USA.
Rivfka ShenoyDepartment of Surgery, New York University, New York, NY, USA.
Timothy M PawlikDepartment of Surgery, The Johns Hopkins University, Baltimore, MD, USA.
Jeffrey A NortonDepartment of Surgery, Stanford University, Stanford, CA, USA.
George A PoultsidesDepartment of Surgery, Stanford University, Stanford, CA, USA. gpoultsides@stanford.edu.
Stanford University · USEmory University · USJohns Hopkins University · USMedical College of Wisconsin · USNew York University · USThe Ohio State University · USThe University of Texas Southwestern Medical Center · USUniversity of California, San Diego · USUniversity of California, San Francisco · USUniversity of Wisconsin–Madison · USVanderbilt University · USWake Forest University · USWashington University in St. Louis · US

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

backgroundLymph node metastasis is an established predictor of poor outcome for adrenocortical carcinoma (ACC); however, routine lymphadenectomy during surgical resection of ACC is not widely performed and its therapeutic role remains unclear.

methodsPatients undergoing margin-negative resection for localized ACC were identified from a multi-institutional database. Patients were stratified into 2 groups based on the surgeon's effort or not to perform a lymphadenectomy as documented in the operative note. Clinical, pathologic, and outcome data were compared between the 2 groups.

resultsOf 120 patients who met inclusion criteria from 1993 to 2014, 32 (27 %) underwent lymphadenectomy. Factors associated with lymphadenectomy were tumor size (12 vs. 9.5 cm; p = .007), palpable mass at presentation (26 vs. 12 %; p = .07), suspicious lymph nodes on preoperative imaging (44 vs. 7 %; p < .001), and need for multivisceral resection (78 vs. 36 %; p < .001). Median number of lymph nodes harvested was higher in the lymphadenectomy group (5.5 vs. 0; p < .001). In-hospital mortality (0 vs. 1.3 %; p = .72) and grade 3/4 complication rates (0 vs. 12 %; p = .061) were not significantly different. Patients who underwent lymphadenectomy had improved overall survival (5-year 76 vs. 59 %; p = .041). The benefit of lymphadenectomy on overall survival persisted on multivariate analysis (HR = 0.17; p = .006) controlling for adverse preoperative and intraoperative factors associated with lymphadenectomy, such as tumor size, palpable mass, irregular tumor edges, suspicious nodes on imaging, and multivisceral resection.

conclusionsIn this multicenter study of adrenocortical carcinoma patients undergoing R0 resection, the surgeon's effort to dissect peritumoral lymph nodes was independently associated with improved overall survival.

Indexed as

Lymph Node ExcisionAdrenal Cortex NeoplasmsAdrenalectomyAdrenocortical CarcinomaAdultFemaleHospital MortalityHumansLymphatic MetastasisLymph NodesMaleMiddle AgedPostoperative ComplicationsRetrospective StudiesSurvival RateTumor Burden

Identifiers

PMID27590329
PMCPMC5257294
OpenAlexW2507592341

What OpenQuestion holds

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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.