Assessment of prognostic factors in pediatric adrenocortical tumors: the modified pediatric S-GRAS score in an international multicenter cohort—a work from the ENSAT-PACT working group
Authors' conclusion
In an international multicenter study, we confirmed that the pS-GRAS score is strongly associated with overall survival among patients with pACC. Age, resection status, stage, and Ki67 index are important parameters for risk stratification.
Study context
- Population
- Children with pediatric ACC (pediatric adrenocortical carcinoma (pACC)) from 9 centers in 6 countries (ENSAT-PACT, GPOH-MET, IC-PACT); median age 4 years
- Participants
- 268 children
- Exposure
- pS-GRAS score groups 1–4
- Outcome
- Overall survival (OS)
Methodological detailsprognostic score validation, international, 9 centers, 6 countries
- Prognostic score validation
- International
- 9 centers, 6 countries
Main finding
As reported in the abstract
OS by pS-GRAS group · 5-year
| Group | Value | HR of death |
|---|---|---|
| Group 1 | 98% | |
| Group 2 | 87% | 3.6 (95% CI 1.6-8.2) |
| Group 3 | 43% | 2.8 (95% CI 1.9-4.4) |
| Group 4 | 18% | 2.1 (95% CI 1.7-2.7) |
Value
Group 198%
Group 287%
Group 343%
Group 418%
HR of death
Group 1— not stated in the abstract
Group 23.6 (95% CI 1.6-8.2)
Group 32.8 (95% CI 1.9-4.4)
Group 42.1 (95% CI 1.7-2.7)
Observational data: associations, not effects.
Further findings
Independent predictors of death (multivariable analysis)
- Age: HR of death
- 3.5 (1.8-7.0) (95% CI)
- Resection status: HR of death
- 5.5 (2.7-11.1) (95% CI)
- Tumor stage: HR of death
- 1.9 (1.2-3.0) (95% CI)
- Ki67 index: HR of death
- 1.7 (1.2-2.4) (95% CI)
Infants <4 years
- More often low-risk constellations with better overall survival (OS) for all tumor stages
Original publication
Assessment of prognostic factors in pediatric adrenocortical tumors: the modified pediatric S-GRAS score in an international multicenter cohort—a work from the ENSAT-PACT working group. Eur J Endocrinol. Published 25 June 2024. doi:10.
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