{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T10:20:24Z","timestamp":1783592424555,"version":"3.55.0"},"reference-count":36,"publisher":"Bioscientifica","issue":"5","license":[{"start":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T00:00:00Z","timestamp":1772236800000},"content-version":"vor","delay-in-days":347,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009379","name":"Interdisziplin\u00e4res Zentrum f\u00fcr Klinische Forschung, Universit\u00e4tsklinikum W\u00fcrzburg","doi-asserted-by":"publisher","award":["Z-02CSP\/23"],"award-info":[{"award-number":["Z-02CSP\/23"]}],"id":[{"id":"10.13039\/501100009379","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["314061271-TRR 205"],"award-info":[{"award-number":["314061271-TRR 205"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Inflammation-based scores have been demonstrated to be independent prognostic factors in predicting outcomes in adult adrenocortical carcinoma (ACC). We aimed to investigate the prognostic role of these scores in pediatric adrenocortical carcinoma (pACC) patients. An international multicenter analysis was conducted on a pediatric cohort from 21 ACC centers. Pretreatment inflammation-based scoring parameters, including neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (dNLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR) and serum albumin, as well as clinical parameters, were analyzed. The primary endpoint was 10-year overall survival (OS). One hundred twenty-nine pediatric patients (50.4% females, mean age 87 months) across all tumor stages with a median follow-up of 36 months were included. 107\/108 patients underwent primary surgery, and 62\/106 received systemic treatment at the time of diagnosis. Of 102 patients, 27 died from disease. In the univariable analysis, NLR \u22655 (HR 8.0, 95% CI 3.4\u201319.1), MLR \u22650.28 (HR 4.2, 95% CI 1.7\u201310.4), PLR \u2265190 (HR 4.5, 95% CI 2.0\u201310.4) and dNLR \u22651.44 (HR 5.9, 95% CI 2.3\u201315.5), as well as clinical parameters age \u22654 years (HR 5.5, 95% CI 1.9\u201315.8), tumor stage IV (HR 5.7, 95% CI 2.7\u201311.9) and incomplete resection status (HR 8.0, 95% CI 3.6\u201317.7) were significantly associated with reduced 10-year OS. After multivariable adjustment, only tumor stage IV (HR 336.7, 95% CI 5.8\u201319,518.1) and MLR \u22650.28 (HR 247.1, 95% CI = 3.1\u201319,907.5) were significantly associated with an unfavorable outcome. Inflammation-based scores tend to have prognostic value in pACC and could serve as prognostic tools after further validation in future studies with sufficient case numbers.<\/jats:p>","DOI":"10.1530\/erc-24-0244","type":"journal-article","created":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T12:46:49Z","timestamp":1742302009000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-8","source":"Crossref","is-referenced-by-count":3,"title":["Inflammation-based score in pediatric adrenocortical carcinoma"],"prefix":"10.1530","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3273-1794","authenticated-orcid":true,"given":"Maria","family":"Riedmeier","sequence":"first","affiliation":[{"name":"University Hospital W\u00fcrzburg, Department of Pediatrics, Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, University of Wuerzburg 1 , ,","place":["Wuerzburg, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9181-3995","authenticated-orcid":true,"given":"Jan","family":"Idkowiak","sequence":"additional","affiliation":[{"name":"Department of Metabolism and Systems Science, School of Medicine and Health, University of Birmingham 2 , ,","place":["Birmingham, UK"]},{"name":"Department of Endocrinology and Diabetes, Birmingham Women\u2019s and Children\u2019s NHS Foundation Trust 3 , ,","place":["Birmingham, UK"]},{"name":"Centre of Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, University of Birmingham 4 , ,","place":["Birmingham, UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi","family":"Frey","sequence":"additional","affiliation":[{"name":"University Hospital W\u00fcrzburg, Department of Pediatrics, Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, University of Wuerzburg 1 , ,","place":["Wuerzburg, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4778-8803","authenticated-orcid":true,"given":"Sonir R R","family":"Antonini","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Ribeirao Preto Medical School, University of Sao Paulo 5 , ,","place":["Ribeir\u00e3o Preto, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriela Fernandes Luiz","family":"Canali","sequence":"additional","affiliation":[{"name":"Oncologia, Pequeno Principe Hospital 6 , , ,","place":["Curitiba, Paran\u00e1, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl Friedrich","family":"Classen","sequence":"additional","affiliation":[{"name":"Division of Pediatric Oncology, Hematology and Palliative Medicine Section, Department of Pediatrics and Adolescent Medicine, University Medicine Rostock 7 , ,","place":["Rostock, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nerea","family":"Dom\u00ednguez-Pinilla","sequence":"additional","affiliation":[{"name":"Pediatric Hematology and Oncology Unit, University Hospital 12 de Octubre, i+12 Research Institute 8 , ,","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Fassnacht","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Endocrinology and Diabetes, University Hospital, University of Wuerzburg 9 , ,","place":["Wuerzburg, Germany"]},{"name":"Comprehensive Cancer Centre Mainfranken, University of Wuerzburg Medical Centre 10 , ,","place":["Wuerzburg, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steffen","family":"Fuchs","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology and Hematology, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin 11 , ,","place":["Berlin, Germany"]},{"name":"Berlin Institute of Health at Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin 12 , ,","place":["Berlin, Germany"]},{"name":"German Cancer Consortium (DKTK), partner site Berlin, a partnership between DKFZ and Charit\u00e9-Universit\u00e4tsmedizin Berlin 13 , ,","place":["Berlin, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"H\u00e4rtel","sequence":"additional","affiliation":[{"name":"University Hospital W\u00fcrzburg, Department of Pediatrics, Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, University of Wuerzburg 1 , ,","place":["Wuerzburg, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominika","family":"Jan\u00fas","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Adolescent Endocrinology, Jagiellonian University Medical College, University Children Hospital 14 , ,","place":["Krakow, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald","family":"de Krijger","sequence":"additional","affiliation":[{"name":"Department of Pathology, University Medical Center Utrecht 15 , ,","place":["Utrecht, The Netherlands"]},{"name":"Princess Maxima Center for Pediatric Oncology 16 , ,","place":["Utrecht, The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tezer","family":"Kutluk","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology, Hacettepe University Faculty of Medicine 17 , ,","place":["Ankara, Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ngoc Lan","family":"Bui","sequence":"additional","affiliation":[{"name":"Pediatric Oncology Hematology Center, Vietnam National Children\u2019s Hospital (VNCH) 18 , ,","place":["Hanoi, Vietnam"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jagdish Prasad","family":"Meena","sequence":"additional","affiliation":[{"name":"Division of Pediatric Oncology, Department of Pediatrics, Mother & Child Block, All India Institute of Medical Sciences 19 , ,","place":["New Delhi, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mouna","family":"Mezoued","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Bologhine Hospital 20 , ,","place":["Algiers, Algeria"]},{"name":"Research Laboratory of Endocrinology and Metabolism (LEM1), Benyoucef Benkhedda University 21 , ,","place":["Algiers, Algeria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Munarin","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, Regina Margherita Children\u2019s Hospital 22 , ,","place":["Turin, Italy"]},{"name":"Department of Pediatrics, University of Turin 23 , ,","place":["Turin, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max M","family":"van Noesel","sequence":"additional","affiliation":[{"name":"Princess Maxima Center for Pediatric Oncology 16 , ,","place":["Utrecht, The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nihal \u00d6zdemir","family":"K\u00f6se","sequence":"additional","affiliation":[{"name":"University Hospital W\u00fcrzburg, Department of Pediatrics, Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, University of Wuerzburg 1 , ,","place":["Wuerzburg, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon H","family":"Pearce","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Translational and Clinical Research Institute, Newcastle University 24 , ,","place":["Newcastle upon Tyne, 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