{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:48:45Z","timestamp":1786978125331,"version":"build-2736575974"},"reference-count":19,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,11,30]],"date-time":"2023-11-30T00:00:00Z","timestamp":1701302400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005301","name":"American College of Surgeons","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005301","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Over recent years, there has been increasing adoption of minimally invasive surgery (MIS) in the treatment of adrenocortical carcinoma (ACC). However, MIS has been associated with noncurative resection and locoregional recurrence. We aimed to identify risk factors for margin\u2010positivity among patients who undergo MIS resection for ACC. We hypothesized that a simple nomogram can accurately identify patients most suitable for curative MIS resection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Curative\u2010intent resections for ACC were identified through the National Cancer Database spanning 2010\u20132018. Trends in MIS utilization were reported using Pearson correlation coefficients. Factors associated with margin\u2010positive resection were identified among preoperatively available variables using multivariable logistic regression, then incorporated into a predictive model. Model quality was cross validated using an 80% training data set and 20% test data set.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 1260 ACC cases, 38.6% (486) underwent MIS resection. MIS utilization increased over time at nonacademic centers (\n                      <jats:italic>R<\/jats:italic>\n                      \u2009=\u20090.818,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.007), but not at academic centers (\n                      <jats:italic>R<\/jats:italic>\n                      \u2009=\u20090.009,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.982). Factors associated with margin\u2010positive MIS resection were increasing age, nonacademic center (odds ratio [OR]: 1.8,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006), cT3 (OR: 4.7,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) or cT4 tumors (OR: 14.6,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and right\u2010sided tumors (OR: 2.0,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006). A predictive model incorporating these four factors produced favorable c\u2010statistics of 0.75 in the training data set and 0.72 in the test data set. A pragmatic nomogram was created to enable bedside risk stratification.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>An increasing proportion of ACC are resected via minimally invasive operations, particularly at nonacademic centers. Patient selection based on a few key factors can minimize the risk of noncurative surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jso.27544","type":"journal-article","created":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T01:19:30Z","timestamp":1701393570000},"page":"691-699","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Laparoscopic surgery for adrenocortical carcinoma: Estimating the risk of margin\u2010positive resection"],"prefix":"10.1002","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4139-3686","authenticated-orcid":false,"given":"Kendyl","family":"Carlisle","sequence":"first","affiliation":[{"name":"Division of General and Oncologic Surgery, Department of Surgery University of Maryland Baltimore Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle W.","family":"Blackburn","sequence":"additional","affiliation":[{"name":"Division of General and Oncologic Surgery, Department of Surgery University of Maryland Baltimore Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily A.","family":"Japp","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Maryland School of Medicine Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick F.","family":"McArdle","sequence":"additional","affiliation":[{"name":"Department of Epidemiology &amp; Public Health University of Maryland School of Medicine Baltimore Maryland USA"},{"name":"Maryland Surgery, Pharmacy, and Anesthesiology Research Collaborative Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas J.","family":"Turner","sequence":"additional","affiliation":[{"name":"Division of General and Oncologic Surgery, Department of Surgery University of Maryland Baltimore Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia H.","family":"Terhune","sequence":"additional","affiliation":[{"name":"Division of General and Oncologic Surgery, Department of Surgery University of Maryland Baltimore Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian R.","family":"Englum","sequence":"additional","affiliation":[{"name":"Division of General and Oncologic Surgery, Department of Surgery University of Maryland Baltimore Baltimore Maryland USA"},{"name":"Maryland Surgery, Pharmacy, and Anesthesiology Research Collaborative Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip W.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Virginia School of Medicine Charlottesville Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinin","family":"Hu","sequence":"additional","affiliation":[{"name":"Division of General and Oncologic Surgery, Department of Surgery University of Maryland Baltimore Baltimore Maryland USA"},{"name":"Maryland Surgery, Pharmacy, and Anesthesiology Research Collaborative Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,11,30]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beem.2011.12.006"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa063360"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.23886"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40618-015-0349-9"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2005.09.012"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-09-1096"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-010-0532-2"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2021.0032"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-022-09167-0"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2020.02.043"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2022.3544"},{"key":"e_1_2_9_13_1","unstructured":"American College of Surgeons.National Cancer Database. Accessed June 2022.https:\/\/www.facs.org\/quality-programs\/cancer\/ncdb.2021."},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-18-0608"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2022.04.078"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.23015"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.26418"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.10414"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2018.04.068"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-018-6398-5"}],"container-title":["Journal of Surgical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jso.27544","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,7]],"date-time":"2024-06-07T01:43:11Z","timestamp":1717724591000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jso.27544"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,30]]},"references-count":19,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,3]]}},"alternative-id":["10.1002\/jso.27544"],"URL":"https:\/\/doi.org\/10.1002\/jso.27544","archive":["Portico"],"relation":{},"ISSN":["0022-4790","1096-9098"],"issn-type":[{"value":"0022-4790","type":"print"},{"value":"1096-9098","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,30]]},"assertion":[{"value":"2023-07-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-30","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}