Evidence map›Paper›PMID 35618598›Full record

ReviewClinical genitourinary cancer2022

Association of Surgical Approach With Treatment Burden, Oncological Effectiveness, and Perioperative Morbidity in Adrenocortical Carcinoma.

Kevin B Ginsburg, Akhil A Chandra, Elizabeth A Handorf, Jared P Schober, Ali Mahmoud, Marc C Smaldone, Rosalia Viterbo, Robert G Uzzo, Richard E Greenberg, David Y T Chen and 2 more

Abstract readReview
In one paragraph

Review in Clinical genitourinary cancer, 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
–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

2 citing papers in PubMed.

  1. Review
  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

12 authors.

Kevin B GinsburgDepartment of Surgical Oncology, Division of Urologic Oncology, Fox Chase Cancer Center, Philadelphia PA; Wayne State University Department of Urology, Detroit, MI. Electronic address: kevin.ginsburg@fccc.edu.
Akhil A ChandraDepartment of Surgical Oncology, Division of Urologic Oncology, Fox Chase Cancer Center, Philadelphia PA.
Elizabeth A HandorfBiostatistics and Bioinformatics Facility, Fox Chase Cancer Center, Philadelphia PA.
Jared P SchoberDepartment of Surgical Oncology, Division of Urologic Oncology, Fox Chase Cancer Center, Philadelphia PA.
Ali MahmoudWayne State University Department of Urology, Detroit, MI.
Marc C SmaldoneDepartment of Surgical Oncology, Division of Urologic Oncology, Fox Chase Cancer Center, Philadelphia PA.
Rosalia ViterboDepartment of Surgical Oncology, Division of Urologic Oncology, Fox Chase Cancer Center, Philadelphia PA.
Robert G UzzoDepartment of Surgical Oncology, Division of Urologic Oncology, Fox Chase Cancer Center, Philadelphia PA.
Richard E GreenbergDepartment of Surgical Oncology, Division of Urologic Oncology, Fox Chase Cancer Center, Philadelphia PA.
David Y T ChenDepartment of Surgical Oncology, Division of Urologic Oncology, Fox Chase Cancer Center, Philadelphia PA.
Alexander KutikovDepartment of Surgical Oncology, Division of Urologic Oncology, Fox Chase Cancer Center, Philadelphia PA.
Andres F CorreaDepartment of Surgical Oncology, Division of Urologic Oncology, Fox Chase Cancer Center, Philadelphia PA.

Funding

WORD PROCESSING CENTER--COREP30CA006927 · NCI · RESEARCH INST OF FOX CHASE CAN CTR · PI Margaret von Mehren · 1985 to 2026
$138.8M
NCI NIH HHS P30 CA006927
6 · The paper itself

Abstract

microabstractIn the National Cancer Database (NCDB), patients treated with minimally invasive adrenalectomy (MIA) for adrenocortical carcinoma (ACC) had similar oncological outcomes and cumulative treatment burden with less morbidity compared with open adrenalectomy (OA). Although OA remains the standard of care for adrenal lesions concerninge for malignancy, MIA in appropriately selected patients may offer equivalent oncological outcomes. INTRODUCTION/

backgroundWe investigated the cumulative treatment burden, oncological effectiveness, and perioperative morbidity in patients undergoing MIA compared with (OA) for patients with ACC. PATIENTS AND

methodsWe reviewed the NCDB for patients undergoing surgical resection (MIA vs. OA) for ACC from 2010 to 2017. Inverse probability of treatment weighted logistic regression, negative binomial, and Cox proportional hazards models were fit to assess for an association of surgical approach with cumulative treatment burden (any adjuvant therapy, radiation therapy [RT], and systemic therapy), oncological effectiveness (positive surgical margins [PSM], lymph node yield [LNY], and overall survival [OS]), and perioperative morbidity (length of stay [LOS] and readmission) as appropriate.

resultsWe identified 776 patients that underwent adrenalectomy for ACC, of which 307 underwent MIA. We noted patients with larger tumors (OR 0.82, 95% CI 0.78-0.86, P < .001) were less likely to have MIA prior to IPTW. We did not appreciate a significant association of MIA with cumulative treatment burden or the use of any adjuvant therapy (OR 0.85, 95% CI 0.60-1.21, P = .375), adjuvant RT (OR 0.94, 95% CI 0.59-1.50, P = .801), or adjuvant systemic therapy (OR 0.84, 95% CI 0.58-1.21, P = .352). Patients undergoing MIA had similar oncological effectiveness of surgery and OS when compared with patients which underwent OA. Patients that underwent MIA had a significantly shorter LOS (IRR: 0.74, 95% CI 0.62-0.88, P = .001) and lower odds of readmission (OR 0.46, 95% CI 0.23-0.91, P = .026).

conclusionsAlthough the standard of care for adrenal lesions suspicious for ACC remains OA, in appropriately selected patients, MIA may offer similar oncological effectiveness and cumulative treatment burden, with less morbidity, than OA.

Indexed as

Adrenal Cortex NeoplasmsAdrenocortical CarcinomaLaparoscopyAdrenalectomyHumansMorbidityRetrospective StudiesAdjuvant chemotherapyAdjuvant radiotherapyAdrenalectomyMinimally invasive surgeryOpen surgical therapy

Identifiers

PMID35618598
PMCPMC10027416

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.