The Modified S-GRAS Scoring System for Prognosis in Korean with Adrenocortical Carcinoma
Background 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 progn...
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Korean Endocrine Society
2024-10-01
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| Series: | Endocrinology and Metabolism |
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| Online Access: | http://www.e-enm.org/upload/pdf/enm-2024-2086.pdf |
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| author | 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 |
| author_facet | 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 |
| author_sort | Sun Kyung Baek |
| collection | DOAJ |
| description | Background 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. |
| format | Article |
| id | doaj-art-0716cda26a064d3a8c7e41982617a1bb |
| institution | OA Journals |
| issn | 2093-596X 2093-5978 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Korean Endocrine Society |
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| series | Endocrinology and Metabolism |
| spelling | doaj-art-0716cda26a064d3a8c7e41982617a1bb2025-08-20T01:47:21ZengKorean Endocrine SocietyEndocrinology and Metabolism2093-596X2093-59782024-10-0139580381210.3803/EnM.2024.20862532The Modified S-GRAS Scoring System for Prognosis in Korean with Adrenocortical CarcinomaSun Kyung Baek0Seung Hun Lee1Seung Shin Park2Chang Ho Ahn3Sung Hye Kong4Won Woong Kim5Yu-Mi Lee6Su Jin Kim7Dong Eun Song8Tae-Yon Sung9Kyu Eun Lee10Jung Hee Kim11Kyeong Cheon Jung12Jung-Min Koh13 Department of Internal Medicine, Kyung Hee University Hospital, Seoul, Korea Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Department of Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaBackground 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.http://www.e-enm.org/upload/pdf/enm-2024-2086.pdfadrenocortical carcinomaprognosissurvival analysisrecurrence |
| spellingShingle | 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 The Modified S-GRAS Scoring System for Prognosis in Korean with Adrenocortical Carcinoma Endocrinology and Metabolism adrenocortical carcinoma prognosis survival analysis recurrence |
| title | The Modified S-GRAS Scoring System for Prognosis in Korean with Adrenocortical Carcinoma |
| title_full | The Modified S-GRAS Scoring System for Prognosis in Korean with Adrenocortical Carcinoma |
| title_fullStr | The Modified S-GRAS Scoring System for Prognosis in Korean with Adrenocortical Carcinoma |
| title_full_unstemmed | The Modified S-GRAS Scoring System for Prognosis in Korean with Adrenocortical Carcinoma |
| title_short | The Modified S-GRAS Scoring System for Prognosis in Korean with Adrenocortical Carcinoma |
| title_sort | modified s gras scoring system for prognosis in korean with adrenocortical carcinoma |
| topic | adrenocortical carcinoma prognosis survival analysis recurrence |
| url | http://www.e-enm.org/upload/pdf/enm-2024-2086.pdf |
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