Evidence map›Paper›PMID 40149347›Full record

ArticleCancers2025

Multidisciplinary Tumor Board Evaluation of Pediatric Patients with Adrenocortical Tumors Across Seven International Centers.

Maria Riedmeier, Wiebke Schlötelburg, Shipra Agarwal, Ahitagni Biswas, Saniye Ekinci, Martin Fassnacht, Maria C B Villares Fragoso, E Nazli Gonc, Melis Gultekin, Mithat Haliloglu and 11 more

Abstract read
In one paragraph

Article in Cancers, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 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

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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

21 authors.

Maria RiedmeierDepartment of Pediatrics, Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, University Hospital Würzburg, University of Wuerzburg, Josef-Schneiderstr. 2, 97080 Wuerzburg, Germany.ORCID 0000-0002-3273-1794
Wiebke SchlötelburgDepartment of Nuclear Medicine, University Hospital Würzburg, University of Wuerzburg, Oberdürrbacherstrasse 6, 97080 Wuerzburg, Germany.
Shipra AgarwalDepartment of Pathology, All India Institute of Medical Sciences, New Delhi 110029, India.ORCID 0000-0001-7037-4444
Ahitagni BiswasDepartment of Radiation Oncology, All India Institute of Medical Sciences, New Delhi 110029, India.ORCID 0000-0002-3453-5340
Saniye EkinciDepartment of Pediatric Surgery, Hacettepe University Faculty of Medicine, 06100 Ankara, Türkiye.ORCID 0000-0002-2961-7069
Martin FassnachtDepartment of Medicine, Division of Endocrinology and Diabetes, University Hospital Würzburg, University of Wuerzburg, Oberdürrbacherstrasse 6, 97080 Wuerzburg, Germany.ORCID 0000-0001-6170-6398
Maria C B Villares FragosoDisciplina de Endocrinologia e Metabologia Adrenal Unit, Instituto do Câncer do Estado de São Paulo, Hospital das Clinicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo 01246-000, Brazil.
E Nazli GoncDepartment of Pediatric Endocrinology, Hacettepe University Faculty of Medicine, 06100 Ankara, Türkiye.ORCID 0000-0003-1385-2563
Melis GultekinDepartment of Radiation Oncology, Hacettepe University Faculty of Medicine, 06100 Ankara, Türkiye.ORCID 0000-0002-1806-2619
Mithat HalilogluDepartment of Pediatric Radiology, Hacettepe University Faculty of Medicine, 06100 Ankara, Türkiye.
Vishesh JainPediatric Surgery, All India Institute of Medical Sciences, New Delhi 110029, India.ORCID 0000-0002-9273-097X
Manisha JanaRadiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi 110029, India.
Dominika JanusDepartment of Pediatric and Adolescent Endocrinology, Jagiellonian University Medical College, University Children Hospital, 31-008 Krakow, Poland.ORCID 0000-0002-3870-368X
Jagdish Prasad MeenaDivision of Pediatric Oncology, Department of Pediatrics, Mother & Child Block, All India Institute of Medical Sciences, New Delhi 110029, India.ORCID 0000-0001-6024-9762
Jessica MunarinDepartment of Pediatric Endocrinology, Regina Margherita Children's Hospital, 10126 Turin, Italy.
Diclehan OrhanDepartment of Pathology, Hacettepe University Faculty of Medicine, 06100 Ankara, Türkiye.
Jaydira Del RiveroDevelopmental Therapeutics Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA.ORCID 0000-0001-9710-4030
Rajni SharmaDivision of Pediatric Endocrinology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India.
Gerdi TuliDepartment of Pediatric Endocrinology, Regina Margherita Children's Hospital, 10126 Turin, Italy.ORCID 0000-0001-5862-8958
Bilgehan YalcinDepartment of Pediatric Oncology, Hacettepe University Faculty of Medicine, 06100 Ankara, Türkiye.
Verena WiegeringDepartment of Pediatrics, Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, University Hospital Würzburg, University of Wuerzburg, Josef-Schneiderstr. 2, 97080 Wuerzburg, Germany.ORCID 0000-0002-2802-4034

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe management of rare tumors at reference centers with specialized multidisciplinary tumor boards (MTBs) improves patient survival. No international standardized diagnostic and treatment recommendations for pediatric patients with adrenocortical carcinoma (ACC) exist so far. The aim of this case-based study is to determine how congruent treatment recommendations are in different specialized institutions in different countries.

methodsIn this cross-sectional, case-based survey study, five anonymized patient cases, including imaging data of pediatric adrenocortical carcinomas (pACCs), were distributed to seven international specialized centers located in Brazil, Germany, India, Italy, Poland, Turkey, and the USA. The centers were tasked with providing recommendations regarding the treatment sequence and modalities, as well as indicating the level of consensus on these decisions within their MTBs. For each case, the treatment approach recommended by the highest number of centers was recorded to calculate an agreement percentage relative to all treatment recommendations made. The consensus level for each case was determined on a scale of 1 to 10, with higher scores indicating greater agreement among MTB members.

resultsA total of five patient cases were discussed across seven MTBs, yielding a total of 34 treatment recommendations. The agreement percentages for the primary therapeutic approach for each case were as follows: primary therapeutic approach: 88.6%; surgical approaches: 51.8%; and systemic chemotherapy recommendations: 53%.

conclusionsThis study represents the first case-based analysis of international inter-center agreement on pediatric ACC management. Inter-center agreement regarding treatment allocation and sequencing was low, while the level of consensus within each MTB was high. These findings point to potentially significant and clinically relevant differences in treatment standards across centers, highlighting the need for international collaboration and standardized diagnostic and therapeutic recommendations, especially for rare tumors. Increased case-based exchanges between centers are essential to reduce the substantial discrepancies observed here and to further standardize the management of pediatric patients with ACC.

Indexed as

guidelineinter-center agreementpediatric ACCreference centerring studytherapy recommendation

Identifiers

PMID40149347
PMCPMC11940591

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.