Prognostic Value of Microscopic Tumor Necrosis in Adrenal Cortical Carcinoma Article Swipe
Michaela Luconi
,
Giulia Cantini
,
Rachel S. van Leeuwaarde
,
Rogina Roebaar
,
Laura Fei
,
Arianna Pia Propato
,
Raffaella Santi
,
Tonino Ercolino
,
Massimo Mannelli
,
Letizia Canu
,
Ronald R. de Krijger
,
Gabriella Nesi
·
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1007/s12022-023-09760-6
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1007/s12022-023-09760-6
Adrenal cortical carcinoma (ACC) is an uncommon neoplasm with variable prognosis. Several histologic criteria have been identified as predictors of malignancy in adrenal cortical tumors. The Weiss score is the system most widely employed for diagnostic purposes, but also possesses prognostic value. We aim to determine the relative impact of each Weiss parameter on ACC patient survival. A multicenter retrospective analysis was conducted on a series of 79 conventional ACCs surgically treated at the Florence and Utrecht centers of the European Network for the Study of Adrenal Tumors (ENSAT). Weiss classification was recapitulated using principal component analysis (PCA). The Kaplan–Meier and Cox multivariate regression analyses were applied in order to estimate the prognostic power of Weiss versus other clinical parameters. PCA reduced the nine Weiss parameters to the best fitting 4-component model, each parameter clustering with a single component. Necrosis and venous invasion clustered together with the highest scores, thus establishing the most relevant component (Component 1) to explain Weiss distribution variability. Only Component 1 significantly predicted overall survival (OS, log-rank = 0.008) and disease-free survival (DFS, log-rank < 0.001). When considering the prognostic power of Weiss parameters, necrosis alone could independently assess OS (log-rank = 0.004) and DFS (log-rank < 0.001) at both the Kaplan–Meier and multivariate Cox regression analyses [hazard ratio (HR) = 7.8, 95% confidence interval [CI] = 1.0–63.5, p = 0.05, and HR = 12.2, 95% CI = 1.6–95.0, p = 0.017, respectively]. The presence of necrosis significantly shortened time to survival (TtS) and time to recurrence (TtR), 57.5 [31.5–103.5] vs 34 [12–78] months ( p = 0.05) and 57.5 [31.5–103.5] vs 7 [1.0–31.5] months ( p < 0.001), respectively. Our study suggests that, of the Weiss parameters, necrosis is the most powerful adverse factor and the best predictor of OS and DFS in ACC patients.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1007/s12022-023-09760-6
- https://link.springer.com/content/pdf/10.1007/s12022-023-09760-6.pdf
- OA Status
- hybrid
- Cited By
- 10
- References
- 21
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4360600426
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4360600426Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1007/s12022-023-09760-6Digital Object Identifier
- Title
-
Prognostic Value of Microscopic Tumor Necrosis in Adrenal Cortical CarcinomaWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2023Year of publication
- Publication date
-
2023-03-23Full publication date if available
- Authors
-
Michaela Luconi, Giulia Cantini, Rachel S. van Leeuwaarde, Rogina Roebaar, Laura Fei, Arianna Pia Propato, Raffaella Santi, Tonino Ercolino, Massimo Mannelli, Letizia Canu, Ronald R. de Krijger, Gabriella NesiList of authors in order
- Landing page
-
https://doi.org/10.1007/s12022-023-09760-6Publisher landing page
- PDF URL
-
https://link.springer.com/content/pdf/10.1007/s12022-023-09760-6.pdfDirect link to full text PDF
- Open access
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YesWhether a free full text is available
- OA status
-
hybridOpen access status per OpenAlex
- OA URL
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https://link.springer.com/content/pdf/10.1007/s12022-023-09760-6.pdfDirect OA link when available
- Concepts
-
Proportional hazards model, Hazard ratio, Internal medicine, Medicine, Adrenocortical carcinoma, Log-rank test, Survival analysis, Confidence interval, Oncology, Necrosis, Multivariate statistics, Malignancy, Pathology, Statistics, MathematicsTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
10Total citation count in OpenAlex
- Citations by year (recent)
-
2025: 4, 2024: 4, 2023: 2Per-year citation counts (last 5 years)
- References (count)
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21Number of works referenced by this work
- Related works (count)
-
10Other works algorithmically related by OpenAlex
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| abstract_inverted_index.European | 81 |
| abstract_inverted_index.Florence | 75 |
| abstract_inverted_index.Necrosis | 140 |
| abstract_inverted_index.analyses | 105, 211 |
| abstract_inverted_index.analysis | 61, 97 |
| abstract_inverted_index.clinical | 119 |
| abstract_inverted_index.cortical | 2, 24 |
| abstract_inverted_index.criteria | 14 |
| abstract_inverted_index.employed | 34 |
| abstract_inverted_index.estimate | 111 |
| abstract_inverted_index.interval | 219 |
| abstract_inverted_index.invasion | 143 |
| abstract_inverted_index.log-rank | 171, 178 |
| abstract_inverted_index.necrosis | 189, 241, 283 |
| abstract_inverted_index.neoplasm | 8 |
| abstract_inverted_index.powerful | 287 |
| abstract_inverted_index.presence | 239 |
| abstract_inverted_index.relative | 48 |
| abstract_inverted_index.relevant | 154 |
| abstract_inverted_index.suggests | 277 |
| abstract_inverted_index.survival | 169, 176, 246 |
| abstract_inverted_index.together | 145 |
| abstract_inverted_index.uncommon | 7 |
| abstract_inverted_index.variable | 10 |
| abstract_inverted_index.(log-rank | 195, 200 |
| abstract_inverted_index.Component | 164 |
| abstract_inverted_index.[12–78] | 257 |
| abstract_inverted_index.carcinoma | 3 |
| abstract_inverted_index.clustered | 144 |
| abstract_inverted_index.component | 96, 155 |
| abstract_inverted_index.conducted | 63 |
| abstract_inverted_index.determine | 46 |
| abstract_inverted_index.parameter | 53, 134 |
| abstract_inverted_index.patients. | 300 |
| abstract_inverted_index.possesses | 40 |
| abstract_inverted_index.predicted | 167 |
| abstract_inverted_index.predictor | 293 |
| abstract_inverted_index.principal | 95 |
| abstract_inverted_index.purposes, | 37 |
| abstract_inverted_index.shortened | 243 |
| abstract_inverted_index.survival. | 57 |
| abstract_inverted_index.(Component | 156 |
| abstract_inverted_index.clustering | 135 |
| abstract_inverted_index.component. | 139 |
| abstract_inverted_index.confidence | 218 |
| abstract_inverted_index.diagnostic | 36 |
| abstract_inverted_index.histologic | 13 |
| abstract_inverted_index.identified | 17 |
| abstract_inverted_index.malignancy | 21 |
| abstract_inverted_index.parameters | 126 |
| abstract_inverted_index.predictors | 19 |
| abstract_inverted_index.prognosis. | 11 |
| abstract_inverted_index.prognostic | 41, 113, 184 |
| abstract_inverted_index.recurrence | 251 |
| abstract_inverted_index.regression | 104, 210 |
| abstract_inverted_index.surgically | 71 |
| abstract_inverted_index.1.0–63.5, | 222 |
| abstract_inverted_index.1.6–95.0, | 233 |
| abstract_inverted_index.4-component | 131 |
| abstract_inverted_index.considering | 182 |
| abstract_inverted_index.multicenter | 59 |
| abstract_inverted_index.parameters, | 188, 282 |
| abstract_inverted_index.parameters. | 120 |
| abstract_inverted_index.[1.0–31.5] | 268 |
| abstract_inverted_index.conventional | 69 |
| abstract_inverted_index.disease-free | 175 |
| abstract_inverted_index.distribution | 161 |
| abstract_inverted_index.establishing | 151 |
| abstract_inverted_index.multivariate | 103, 208 |
| abstract_inverted_index.variability. | 162 |
| abstract_inverted_index.independently | 192 |
| abstract_inverted_index.recapitulated | 93 |
| abstract_inverted_index.respectively. | 274 |
| abstract_inverted_index.retrospective | 60 |
| abstract_inverted_index.significantly | 166, 242 |
| abstract_inverted_index.Kaplan–Meier | 100, 206 |
| abstract_inverted_index.[31.5–103.5] | 254, 265 |
| abstract_inverted_index.classification | 91 |
| abstract_inverted_index.respectively]. | 237 |
| cited_by_percentile_year.max | 98 |
| cited_by_percentile_year.min | 94 |
| corresponding_author_ids | https://openalex.org/A5016806501 |
| countries_distinct_count | 2 |
| institutions_distinct_count | 12 |
| corresponding_institution_ids | https://openalex.org/I45084792 |
| sustainable_development_goals[0].id | https://metadata.un.org/sdg/3 |
| sustainable_development_goals[0].score | 0.7900000214576721 |
| sustainable_development_goals[0].display_name | Good health and well-being |
| citation_normalized_percentile.value | 0.93147186 |
| citation_normalized_percentile.is_in_top_1_percent | False |
| citation_normalized_percentile.is_in_top_10_percent | True |