title: Prevalence and Prognostic Value of Lymph Node Dissection in Treating Adrenocortical Carcinoma: A National Experience.
abstract: OBJECTIVE
  We examined a national database to investigate the role of lymph node dissection (LND) in adrenocortical carcinoma (ACC) treated surgically.
  
  
  METHODS
  Patient data diagnosed with ACC between 1991 and 2011 were extracted from a national database. Predictors of LND, positive lymph nodes on LND, and the association between positive LND and cancer-specific death were examined.
  
  
  RESULTS
  Only 5.39% of patients underwent LND, and 31.03% had positive lymph nodes. Disease stage was the only significant predictor of LND (odds ratio=3.061; 95% confidence interval=1.158-8.091), and finding more than one positive lymph nodes on LND was the only significant predictor of cancer-specific death (hazard ratio=3.13; 95% confidence interval=1.233-7.95) in tumors larger than 3 cm in size.
  
  
  CONCLUSIONS
  LND is not a common practice in treating ACC in the United States. The finding of more than one positive lymph nodes on LND for ACC is associated with poor prognosis.
authors.affiliation: Division of Urology, Department of Surgery, Southern Illinois University School of Medicine, Springfield, IL, U.S.A. salanee@siumed.edu.
authors.forename: Shaheen
authors.initials: S
authors.lastname: Alanee
authors.affiliation: Division of Urology, Department of Surgery, Southern Illinois University School of Medicine, Springfield, IL, U.S.A.
authors.forename: Danuta
authors.initials: D
authors.lastname: Dynda
authors.affiliation: Division of Urology, Department of Surgery, Southern Illinois University School of Medicine, Springfield, IL, U.S.A.
authors.forename: Bradley
authors.initials: B
authors.lastname: Holland
mesh_terms: D018268:Adrenocortical Carcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision / Q000401:mortality* / Q000706:statistics & numerical data*; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D015995:Prevalence; D011379:Prognosis; D018426:SEER Program; D015996:Survival Rate
keywords: Adrenocortical carcinoma; lymph node dissection; prevalence; prognosis