Evidence map›Paper›PMID 41266918›Full record

ArticleAnnals of surgical oncology2026

Surgical Management and Outcomes in Pediatric Adrenocortical Carcinoma: A Pediatric Surgical Oncology Research Collaborative Study.

Shachi Srivatsa, Jennifer H Aldrink, Md Rejuan Haque, Andrew Murphy, Daniel Gehle, Huma Halepota, Erika A Newman, Keyonna Williams, Peter Mattei, William R Johnston and 47 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing 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

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
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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

57 authors.

Shachi SrivatsaCenter for Surgical Outcomes and Research, Abigail Wexner Research Institute, Division of Pediatric Surgery, Department of Surgery, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA.
Jennifer H AldrinkDivision of Pediatric Surgery, Department of Surgery, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA.
Md Rejuan HaqueDepartment of Biomedical Informatics, The Ohio State University, Columbus, OH, USA.
Andrew MurphyDepartment of Surgery, St Jude Children's Research Hospital, Memphis, TN, USA.
Daniel GehleDepartment of Surgery, St Jude Children's Research Hospital, Memphis, TN, USA.
Huma HalepotaDepartment of Surgery, St Jude Children's Research Hospital, Memphis, TN, USA.
Erika A NewmanC.S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI, USA.
Keyonna WilliamsC.S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI, USA.
Peter MatteiGeneral, Thoracic and Fetal Surgery, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
William R JohnstonGeneral, Thoracic and Fetal Surgery, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Rosa HwangGeneral, Thoracic and Fetal Surgery, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Timothy B LautzDepartment of Surgery, Division of Pediatric Surgery, Lurie Children's Hospital, Northwestern School of Medicine, Chicago, IL, USA.
Samantha A AyalaDepartment of Surgery, Division of Pediatric Surgery, Lurie Children's Hospital, Northwestern School of Medicine, Chicago, IL, USA.
Nelson PichéDivision of Pediatric Surgery, Centre Hospitalier Universitaire Ste-Justine, Université de Montréal, Montréal, Canada.
Caroline P LemoineDivision of Pediatric Surgery, Centre Hospitalier Universitaire Ste-Justine, Université de Montréal, Montréal, Canada.
Julia DebertinDepartment of Surgery, Mayo Clinic, Rochester, MN, USA.
Stephanie F PolitesDepartment of Surgery, Mayo Clinic, Rochester, MN, USA.
David H RothsteinSeattle Children's Hospital, University of Washington, Seattle, WA, USA.
Kimberly J RiehleSeattle Children's Hospital, University of Washington, Seattle, WA, USA.
Nzuekoh NchindaSeattle Children's Hospital, University of Washington, Seattle, WA, USA.
Marcus M MalekDivision of Pediatric General and Thoracic Surgery, University of Pittsburgh Medical Center (UPMC) Children's Hospital of Pittsburgh, Pittsburgh, PA, USA.
Hannah N RinehardtDivision of Pediatric General and Thoracic Surgery, University of Pittsburgh Medical Center (UPMC) Children's Hospital of Pittsburgh, Pittsburgh, PA, USA.
Catherine GestrichDivision of Pathology, University of Pittsburgh Medical Center (UPMC) Children's Hospital of Pittsburgh, Pittsburgh, PA, USA.
Shannon L CastleDivision of Pediatric Surgery, Valley Children's Hospital, Madera, CA, USA.
Adriana LopezValley Children's Hospital, Madera, CA, USA.
Matthew S MayesValley Children's Hospital, Madera, CA, USA.
Emily K MyersDivision of Pediatric Surgery, Department of Surgery, University of Colorado School of Medicine, Children's Hospital of Colorado, Aurora, CO, USA.
Jonathan P RoachDivision of Pediatric Surgery, Department of Surgery, University of Colorado School of Medicine, Children's Hospital of Colorado, Aurora, CO, USA.
Brian T CraigDivision of Pediatric Surgery, Medical College of Wisconsin, Children's Wisconsin, Milwaukee, WI, USA.
Dave R LalDivision of Pediatric Surgery, Medical College of Wisconsin, Children's Wisconsin, Milwaukee, WI, USA.
Jennifer SchuhDivision of Pediatric Surgery, Medical College of Wisconsin, Children's Wisconsin, Milwaukee, WI, USA.
Barrett P CromeensDivision of Pediatric Surgery, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN, USA.
Sindhu V MannavaDivision of Pediatric Surgery, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN, USA.
Mary T AustinMD Anderson Cancer Center, University of Texas, Houston, TX, USA.
Lauren K MayonMD Anderson Cancer Center, University of Texas, Houston, TX, USA.
Zachary J KastenbergDepartment of Surgery, Division of Pediatric Surgery, University of Utah, Primary Children's Hospital, Salt Lake City, UT, USA.
Marshall WallaceDepartment of Surgery, Division of Pediatric Surgery, University of Utah, Primary Children's Hospital, Salt Lake City, UT, USA.
Abigail AlexanderDepartment of Surgery, Division of Pediatric Surgery, University of Utah, Primary Children's Hospital, Salt Lake City, UT, USA.
Michael A StellonDivision of Pediatric Surgery, American Family Children's Hospital, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA.
Hau D LeDivision of Pediatric Surgery, American Family Children's Hospital, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA.
Devashish S JoshiDivision of Pediatric Surgery, American Family Children's Hospital, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA.
Charbel ChidiacDivision of Pediatric Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Daniel S RheeDivision of Pediatric Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Danielle CameronMassachusetts General Hospital, Boston, MA, USA.
Alyssa StetsonMassachusetts General Hospital, Boston, MA, USA.
Barrie S RichFeinstein/Northwell, Cohen Children's Medical Center, Queens, NY, USA.
Richard D GlickFeinstein/Northwell, Cohen Children's Medical Center, Queens, NY, USA.
Elizabeth A FialkowskiDepartment of Surgery, Oregon Health & Science University, Portland, OR, USA.
Kathryn FowlerDepartment of Surgery, Oregon Health & Science University, Portland, OR, USA.
Rukaya FarehDepartment of Surgery, Oregon Health & Science University, Portland, OR, USA.
Erin G BrownDivision of Pediatric Surgery, Department of Surgery, University of California Davis Children's Hospital, Sacramento, CA, USA.
Kathleen DoyleDepartment of Surgery, University of California Davis, Sacramento, CA, USA.
Paige AbrilDepartment of Surgery, University of California Davis, Sacramento, CA, USA.
Christa GrantNew York Medical College, Valhalla, NY, USA.
Roshni DasguptaDivision of Pediatric Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Chloé BoehmerDivision of Pediatric Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Sara A MansfieldDivision of Pediatric Surgery, Department of Surgery, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA. Sara.mansfield@nationwidechildrens.org.ORCID http://orcid.org/0000-0002-2868-0947

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPediatric adrenocortical carcinoma (ACC) is a rare and aggressive cancer. The appropriateness of minimally invasive surgery (MIS), role of nodal dissection, and aggressiveness of surgery in patients with metastatic disease remain poorly understood. PATIENTS AND

methodsWe performed a retrospective review of patients < 18 years with ACC treated from 2012 to 2022 at 22 institutions participating in the Pediatric Surgical Oncology Research Collaborative. Data collected included demographics, clinical presentation, genetic predisposition, tumor characteristics, surgical approach, adjuvant treatment, and survival outcome. Survival probabilities were estimated with Kaplan-Meier methods.

resultsIn all, 69 patients were included (median age: 8.4 years; 58% female), and 28% had Li-Fraumeni syndrome. At diagnosis, 36% had Stage IV disease and 28% had Stage I disease. A total of 55 (83%) patients underwent open adrenalectomy, and 11 (17%) underwent MIS. MIS approaches were employed for significantly smaller tumors (median: 4.4 cm, 38 g) compared with open cases (median: 9.6 cm, 246 g; p < 0.001), and none had tumor spillage (versus 22% in open cases; p = 0.087). Lymph node sampling was performed in 44% of open cases (mean yield: 2.96); no lymph nodes were sampled in MIS cases (p = 0.008). The 5 year overall survival (OS) for the entire cohort was 65.9%, and 5-year event-free survival (EFS) was 54.1%. Patients without metastases had significantly better survival than those with more than five metastatic lesions (5 year OS: 84.5% versus 11.9%; p < 0.001).

conclusionsComplete surgical resection remains paramount for cure in children with ACC. Despite aggressive attempts at tumor clearance, outcomes in children with metastatic disease remain poor. Nodal dissection remains infrequently and incompletely performed, limiting conclusions on impact.

Indexed as

Adrenal Cortex NeoplasmsAdrenalectomyAdrenocortical CarcinomaMinimally Invasive Surgical ProceduresAdolescentChildChild, PreschoolFemaleFollow-Up StudiesHumansInfantLymph Node ExcisionMalePrognosisRetrospective StudiesSurvival RateAdrenal tumorAdrenocortical carcinomaLi–Fraumeni syndromeMinimally invasive surgeryOutcomesPediatric

Identifiers

PMID41266918

What Socratic holds

Textmetadata
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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 Socratic graph.