Evidence map›Paper›PMID 33586069›Full record

ArticleAnnals of surgical oncology2021

Cumulative GRAS Score as a Predictor of Survival After Resection for Adrenocortical Carcinoma: Analysis From the U.S. Adrenocortical Carcinoma Database.

Jordan J Baechle, Paula Marincola Smith, Carmen C Solórzano, Thuy B Tran, Lauren M Postlewait, Shishir K Maithel, Jason Prescott, Timothy Pawlik, Tracy S Wang, Jason Glenn and 17 more

Abstract read
PubMed Publisher
In one paragraph

Article in Annals of surgical oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
2.7field-weighted citation impact, top 10% 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

9 citing papers in PubMed, 13 citations in OpenAlex.

  1. Observational
  2. Article
  3. Article
  4. Article
  5. Pathological and Genetic Stratification for Management of Adrenocortical Carcinoma.The Journal of clinical endocrinology and metabolism · 2022
    Review
  6. Article
  7. Article
  8. Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

27 authors at 15 institutions in 1 country.

Jordan J BaechleDepartment of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
Paula Marincola SmithDepartment of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
Carmen C SolórzanoDepartment of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
Thuy B TranDepartment of Surgery, Stanford Medical Center, Stanford, CA, USA.
Lauren M PostlewaitDepartment of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA, USA.
Shishir K MaithelDepartment of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA, USA.
Jason PrescottDepartment of Surgery, The Johns Hopkins Medical Center, Baltimore, MD, USA.
Timothy PawlikDepartment of Surgery, The Johns Hopkins Medical Center, Baltimore, MD, USA.
Tracy S WangDepartment of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA.
Jason GlennDepartment of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA.
Ioannis HatzarasDepartment of Surgery, New York University Langone Health, New York, NY, USA.
Rivfka ShenoyDepartment of Surgery, New York University Langone Health, New York, NY, USA.
John E PhayDepartment of Surgery, The Ohio State University, Columbus, OH, USA.
Lawrence A ShirleyDepartment of Surgery, The Ohio State University, Columbus, OH, USA.
Ryan C FieldsDepartment of Surgery, Washington University School of Medicine, St Louis, MO, USA.
Linda JinDepartment of Surgery, Washington University School of Medicine, St Louis, MO, USA.
Daniel E AbbottDepartment of General Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA.
Sean Ronnekleiv-KellyDepartment of General Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA.
Jason K SicklickDepartment of Surgery, University of California San Diego, San Diego, CA, USA.
Adam YoppDepartment of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
John MansourDepartment of Surgery, University of Texas Southwestern Medical Center, 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.
Konstantinos VotanopoulosDepartment of Surgery, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Edward A LevineDepartment of Surgery, Wake Forest School of Medicine, Winston-Salem, NC, USA.
George PoultsidesDepartment of Surgery, Stanford Medical Center, Stanford, CA, USA.
Colleen M KiernanDepartment of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA. colleen.m.kiernan@vumc.org.
Vanderbilt University Medical Center · USEmory University · USMedical College of Wisconsin · USNYU Langone Health · USStanford Medicine · USThe Ohio State University · USThe University of Texas Southwestern Medical Center · USUniversity of California, San Francisco · USUniversity of Wisconsin–Madison · USWake Forest University · USWashington University in St. Louis · USJohns Hopkins Bayview Medical Center · USJohns Hopkins University · USMeharry Medical College · USUniversity of California, San Diego · US

Funding

Immune-modulating effects of SMAD4 in colorectal cancerF32CA236309 · NCI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI SMITH, PAULA MARINCOLA · 2019 to 2020
$113k
NCI NIH HHS F32 CA236309
6 · The paper itself

Abstract

backgroundAdrenocortical carcinoma (ACC) is a rare but aggressive malignancy, and many prognostic factors that influence survival remain undefined. Individually, the GRAS (Grade, Resection status, Age, and Symptoms of hormone hypersecretion) parameters have demonstrated their prognostic value in ACC. This study aimed to assess the value of a cumulative GRAS score as a prognostic indicator after ACC resection.

methodsA retrospective cohort study of adult patients who underwent surgical resection for ACC between 1993 and 2014 was performed using the United States Adrenocortical Carcinoma Group (US-ACCG) database. A sum GRAS score was calculated for each patient by adding one point each when the criteria were met for tumor grade (Weiss criteria ≥ 3 or Ki67 ≥ 20%), resection status (micro- or macroscopically positive margin), age (≥ 50 years), and preoperative symptoms of hormone hypersecretion (present). Overall survival (OS) and disease-free survival (DFS) by cumulative GRAS score were analyzed by the Kaplan-Meier method and log-rank test.

resultsOf the 265 patients in the US-ACCG database, 243 (92%) had sufficient data available to calculate a cumulative GRAS score and were included in this analysis. The 265 patients comprised 23 patients (10%) with a GRAS of 0, 52 patients (21%) with a GRAS of 1, 92 patients (38%) with a GRAS of 2, 63 patients (26%) with a GRAS of 3, and 13 patients (5%) with a GRAS of 4. An increasing GRAS score was associated with shortened OS (p < 0.01) and DFS (p < 0.01) after index resection.

conclusionIn this retrospective analysis, the cumulative GRAS score effectively stratified OS and DFS after index resection for ACC. Further prospective analysis is required to validate the cumulative GRAS score as a prognostic indicator for clinical use.

Indexed as

Adrenal Cortex NeoplasmsAdrenocortical CarcinomaAdultDisease-Free SurvivalHumansMiddle AgedPrognosisRetrospective StudiesUnited States

Identifiers

PMID33586069
OpenAlexW3132932517

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.