{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T18:45:14Z","timestamp":1775155514264,"version":"3.50.1"},"reference-count":26,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2022,3,14]],"date-time":"2022-03-14T00:00:00Z","timestamp":1647216000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Adrenocortical carcinoma (ACC) is associated with a poor prognosis. We reviewed the National Cancer Database (NCDB) to analyze the prognostic factors in surgically resected ACC patients and the association of surgical approaches with overall survival (OS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective NCDB (2004\u20132014) review of patients undergoing curative\u2010intent surgical resection for ACC was performed. Effects of patient demographics, tumor characteristics, histopathology, and perioperative course on OS were analyzed. Log\u2010rank statistics were used to associate clinical variables with OS. The multivariable Cox proportional hazard model included only statistically significant variables.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1599 patients with ACC were included. A majority of patients were female (60.73%) and presented with a Charlson\u2013Deyo score of zero (75.42%). A majority of the ACC cases were Grade 3 (45.69%), and almost a third (30.64%) underwent margin\u2010positive resections. Univariate analysis demonstrated a decrease in OS associated with increasing age and comorbidities. A negative resection margin and lack of lymphovascular invasion predicted better OS. Multivariable analysis showed that age, grade, surgical resection margins, and hospital length of stay were associated with OS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Advanced age, grade, presence of lymphovascular invasion, and positive surgical margins predicted a worse overall survival for adrenocortical cancer in our analysis. Resection with negative margins improves outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.26845","type":"journal-article","created":{"date-parts":[[2022,3,14]],"date-time":"2022-03-14T16:45:00Z","timestamp":1647276300000},"page":"1224-1230","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Surgical resection for adrenocortical carcinoma: Current trends affecting survival"],"prefix":"10.1002","volume":"125","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2427-9988","authenticated-orcid":false,"given":"Monali","family":"Shah","sequence":"first","affiliation":[{"name":"Department of Medicine Philadelphia College of Osteopathic Medicine, South Georgia  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel E.","family":"NeMoyer","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Surgical Oncology Rutgers Cancer Institute of New Jersey, Rutgers Robert Wood Johnson Medical School  New Brunswick New Jersey USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richi","family":"Kashyap","sequence":"additional","affiliation":[{"name":"Department of Medicine Maulana Azad Medical College  Delhi India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Epidemiology, Division of Biometrics, Rutgers Cancer Institute of New Jersey, School of Public Health Rutgers University  Piscataway New Jersey USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan","family":"Sarmiento","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Surgical Oncology Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8694-0455","authenticated-orcid":false,"given":"David 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