| Title |
The Impact of Nodal Dissection on Staging in Adrenocortical Carcinoma
|
|---|---|
| Published in |
Annals of Surgical Oncology, September 2017
|
| DOI | 10.1245/s10434-017-6064-3 |
| Pubmed ID | |
| Authors |
Suraj Panjwani, Maureen D. Moore, Katherine D. Gray, Brendan M. Finnerty, Toni Beninato, Laurent Brunaud, Thomas J. Fahey, Rasa Zarnegar |
| Abstract |
The role of lymphadenectomy in adrenocortical carcinoma (ACC) is controversial, and formal lymph node (LN) dissection is not routine. We sought to determine the minimum number of LNs that must be examined to accurately identify a patient as node negative. The National Cancer Database was used to identify patients diagnosed with ACC from 2004 to 2013 who underwent surgical resection. Patients with distant metastases, multivisceral resection, or missing surgical or lymphadenectomy data were excluded. The primary outcome was overall survival (OS). LNs were identified on histopathology in 156 patients. Of these, 35 (22%) had at least one positive LN. Positive LNs were associated with positive surgical margins (odds ratio [OR] 5.80, p = 0.002) and increasing LN yield (OR 1.06, p = 0.02). Overall, on Cox regression analysis, LN positivity (hazard ratio [HR] 3.02, p < 0.001) and positive surgical margins (HR 2.06, p = 0.048) independently predicted poor OS after controlling for other factors that may influence survival. LN(-) disease in patients with one to three LNs examined had poorer overall survival compared with when at least four LNs were examined (p = 0.02). None of the other patient, tumor, and treatment variables had any impact on OS of the LN(-) cohort. The likelihood of identifying nodal involvement was higher on examination of at least four LNs compared with examination of one to three LNs (30 vs. 16%, p = 0.03). LN positivity in ACC tumors independently predicts worse 5-year OS and a minimum of four LNs may be required to accurately determine LN negativity. |
X Demographics
The data shown below were collected from the profiles of 3 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| India | 1 | 33% |
| Unknown | 2 | 67% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 2 | 67% |
| Practitioners (doctors, other healthcare professionals) | 1 | 33% |
Mendeley readers
The data shown below were compiled from readership statistics for 22 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 22 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 4 | 18% |
| Student > Doctoral Student | 3 | 14% |
| Student > Ph. D. Student | 3 | 14% |
| Professor | 3 | 14% |
| Student > Bachelor | 2 | 9% |
| Other | 2 | 9% |
| Unknown | 5 | 23% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 16 | 73% |
| Agricultural and Biological Sciences | 1 | 5% |
| Mathematics | 1 | 5% |
| Unknown | 4 | 18% |
Attention Score in Context
This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 16 October 2017.
All research outputs
#14,303,442
of 23,005,189 outputs
Outputs from Annals of Surgical Oncology
#4,101
of 6,531 outputs
Outputs of similar age
#174,434
of 316,079 outputs
Outputs of similar age from Annals of Surgical Oncology
#81
of 107 outputs
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