The Modified S-GRAS Scoring System for Prognosis in Korean with Adrenocortical Carcinoma.

IF 3.9 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Endocrinology and Metabolism Pub Date : 2024-10-01 Epub Date: 2024-09-25 DOI:10.3803/EnM.2024.2086
Sun Kyung Baek, Seung Hun Lee, Seung Shin Park, Chang Ho Ahn, Sung Hye Kong, Won Woong Kim, Yu-Mi Lee, Su Jin Kim, Dong Eun Song, Tae-Yon Sung, Kyu Eun Lee, Jung Hee Kim, Kyeong Cheon Jung, Jung-Min Koh
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引用次数: 0

Abstract

Backgruound: Adrenocortical carcinomas (ACCs) are rare tumors with aggressive but varied prognosis. Stage, Grade, Resection status, Age, Symptoms (S-GRAS) score, based on clinical and pathological factors, was found to best stratify the prognosis of European ACC patients. This study assessed the prognostic performance of modified S-GRAS (mS-GRAS) scores including modified grade (mG) by integrating mitotic counts into the Ki67 index (original grade), in Korean ACC patients.

Methods: Patients who underwent surgery for ACC between January 1996 and December 2022 at three medical centers in Korea were retrospectively analyzed. mS-GRAS scores were calculated based on tumor stage, mG (Ki67 index or mitotic counts), resection status, age, and symptoms. Patients were divided into four groups (0-1, 2-3, 4-5, and 6-9 points) based on total mS-GRAS score. The associations of each variable and mS-GRAS score with recurrence and survival were evaluated using Cox regression analysis, Harrell's concordance index (C-index), and the Kaplan-Meier method.

Results: Data on mS-GRAS components were available for 114 of the 153 patients who underwent surgery for ACC. These 114 patients had recurrence and death rates of 61.4% and 48.2%, respectively. mS-GRAS score was a significantly better predictor of recurrence (C-index=0.829) and death (C-index=0.747) than each component (P<0.05), except for resection status. mS-GRAS scores correlated with shorter progression-free survival (P=8.34E-24) and overall survival (P=2.72E-13).

Conclusion: mS-GRAS scores showed better prognostic performance than tumor stage and grade in Asian patients who underwent surgery for ACC.

韩国肾上腺皮质癌患者预后的改良 S-GRAS 评分系统
背景:肾上腺皮质癌(ACC)是一种罕见肿瘤,具有侵袭性,但预后各异。研究发现,基于临床和病理因素的分期、分级、切除状态、年龄、症状(S-GRAS)评分可对欧洲 ACC 患者的预后进行最佳分层。本研究评估了韩国 ACC 患者的改良 S-GRAS 评分(mS-GRAS)的预后效果,包括通过将有丝分裂计数纳入 Ki67 指数(原始分级)而得出的改良分级(mG):根据肿瘤分期、mG(Ki67指数或有丝分裂计数)、切除情况、年龄和症状计算mS-GRAS评分。根据 mS-GRAS 总分将患者分为四组(0-1 分、2-3 分、4-5 分和 6-9 分)。采用 Cox 回归分析、Harrell 一致指数(C-index)和 Kaplan-Meier 法评估了各变量和 mS-GRAS 评分与复发和生存的关系:在153名接受ACC手术的患者中,有114名患者的mS-GRAS成分数据可用。mS-GRAS评分对复发(C-index=0.829)和死亡(C-index=0.747)的预测效果明显优于各组成部分(PC结论:在接受ACC手术的亚洲患者中,mS-GRAS评分的预后效果优于肿瘤分期和分级。
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来源期刊
Endocrinology and Metabolism
Endocrinology and Metabolism Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
6.60
自引率
5.90%
发文量
145
审稿时长
24 weeks
期刊介绍: The aim of this journal is to set high standards of medical care by providing a forum for discussion for basic, clinical, and translational researchers and clinicians on new findings in the fields of endocrinology and metabolism. Endocrinology and Metabolism reports new findings and developments in all aspects of endocrinology and metabolism. The topics covered by this journal include bone and mineral metabolism, cytokines, developmental endocrinology, diagnostic endocrinology, endocrine research, dyslipidemia, endocrine regulation, genetic endocrinology, growth factors, hormone receptors, hormone action and regulation, management of endocrine diseases, clinical trials, epidemiology, molecular endocrinology, neuroendocrinology, neuropeptides, neurotransmitters, obesity, pediatric endocrinology, reproductive endocrinology, signal transduction, the anatomy and physiology of endocrine organs (i.e., the pituitary, thyroid, parathyroid, and adrenal glands, and the gonads), and endocrine diseases (diabetes, nutrition, osteoporosis, etc.).
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