Evidence map›Paper›PMID 35246741›Full record

ArticleSurgical endoscopy2022

Operative approach and case volume are associated with negative resection margins for adrenocortical carcinoma.

Joshua Tseng, Timothy Diperi, Nicholas Gonsalves, Yufei Chen, Anat Ben-Shlomo, Daniel Shouhed, Edward Phillips, Miguel Burch, Monica Jain

Abstract read
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In one paragraph

Article in Surgical endoscopy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
2.0field-weighted citation impact, top 15% 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

2 citing papers in PubMed, 10 citations in OpenAlex.

  1. Article
  2. 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

9 authors at 1 institution in 1 country.

Joshua TsengDivision of Minimally Invasive Surgery and Endocrine Surgery, Department of Surgery, Cedars-Sinai Medical Center, 8635 W. 3rd St., Suite 650, Los Angeles, CA, 90048, USA.
Timothy DiperiDivision of Minimally Invasive Surgery and Endocrine Surgery, Department of Surgery, Cedars-Sinai Medical Center, 8635 W. 3rd St., Suite 650, Los Angeles, CA, 90048, USA.
Nicholas GonsalvesDivision of Minimally Invasive Surgery and Endocrine Surgery, Department of Surgery, Cedars-Sinai Medical Center, 8635 W. 3rd St., Suite 650, Los Angeles, CA, 90048, USA.
Yufei ChenDivision of Minimally Invasive Surgery and Endocrine Surgery, Department of Surgery, Cedars-Sinai Medical Center, 8635 W. 3rd St., Suite 650, Los Angeles, CA, 90048, USA.
Anat Ben-ShlomoAdrenal Program, Pituitary Center, Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Daniel ShouhedDivision of Minimally Invasive Surgery and Endocrine Surgery, Department of Surgery, Cedars-Sinai Medical Center, 8635 W. 3rd St., Suite 650, Los Angeles, CA, 90048, USA.
Edward PhillipsDivision of Minimally Invasive Surgery and Endocrine Surgery, Department of Surgery, Cedars-Sinai Medical Center, 8635 W. 3rd St., Suite 650, Los Angeles, CA, 90048, USA.
Miguel BurchDivision of Minimally Invasive Surgery and Endocrine Surgery, Department of Surgery, Cedars-Sinai Medical Center, 8635 W. 3rd St., Suite 650, Los Angeles, CA, 90048, USA.
Monica JainDivision of Minimally Invasive Surgery and Endocrine Surgery, Department of Surgery, Cedars-Sinai Medical Center, 8635 W. 3rd St., Suite 650, Los Angeles, CA, 90048, USA. monica.jain@cshs.org.ORCID http://orcid.org/0000-0002-6217-7632
Cedars-Sinai Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSurgical resection with negative margins is the treatment of choice for adrenocortical carcinoma (ACC). This study was undertaken to determine factors associated with negative resection margins.

methodsNational Cancer Database was queried from 2010 to 2016 to identify patients with AJCC/ENSAT Stage I-III ACC who underwent adrenalectomy. Patient, tumor, facility, and operative characteristics were compared by margin status (positive-PM or negative-NM) and operative approach (open-OA, laparoscopic-LA, or robotic-RA). Multivariable logistic regression was used to identify factors associated with PM.

resultsEight hundred and eighty-one patients were identified, of which 18.4% had PM and 81.6% had NM. Patients with advanced pathologic T stage and pathologic N1 stage were more likely to have PM (vs. NM) (T3, 49.7% vs. 24.8%, p < 0.01; T4, 26.2% vs. 10.0%, p < 0.01; N1, 6.7% vs. 3.5%, p < 0.01). Patients undergoing OA (vs. LA and RA) were more likely to have advanced clinical T stage (T4, 16.6% vs. 5.7% vs. 7.8%, p < 0.01) and larger tumors (> 6 cm, 84.6% vs. 64.1% vs. 62.3%, p < 0.01). High-volume centers (≥ 5 cases) were more likely to utilize OA. Patients undergoing LA (vs. RA) were more likely to require conversion to open (20.3% vs. 7.8%, p = 0.011). On multivariable analysis, factors associated with higher odds of PM included T3 disease (OR 7.02, 95% CI 2.66-18.55), T4 disease (OR 10.22, 95% CI 3.66-28.53), and LA (OR 1.99, 95% CI 1.28-3.09). High-volume centers were associated with lower odds of PM (OR 0.67, 95% CI 0.45-0.98). There was no significant difference in margin status between OA and RA (OR 1.44, 95% CI 0.71-2.90).

conclusionCenters with higher ACC case volumes have lower odds of PM and utilize OA more often. LA is associated with higher odds of PM, whereas RA is not. These factors should be considered when planning the operative approach for ACC.

Indexed as

Adrenal Cortex NeoplasmsAdrenocortical CarcinomaLaparoscopyAdrenalectomyHumansMargins of ExcisionRetrospective StudiesAdrenocortical carcinomaLaparoscopic surgeryMarginsMinimally invasive surgeryNational Cancer DatabaseRobotic surgery

Identifiers

PMID35246741
OpenAlexW4221008893

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.