OFFICIAL JOURNAL OF THE SOCIETY OF SURGICAL ONCOLOGY
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ASO VISUAL ABSTRACT
ASO Visual Abstract: Surgical Management and Outcomes in Pediatric Adrenocortical Carcinoma: A Pediatric Surgical Oncology Research Collaborative Study
Shachi Srivatsa, MD, MPH1, Jennifer H. Aldrink, MD2, Md Rejuan Haque, PhD3, Andrew Murphy, MD4, Daniel Gehle, MD4, Huma Halepota, MD4, Erika A. Newman, MD5, Keyonna Williams, MD5, Peter Mattei, MD6, William R. Johnston, MD6, Rosa Hwang, BS6, Timothy B. Lautz, MD7, Samantha A. Ayala, BS7, Nelson Piché, MD8, Caroline P. Lemoine, MD8, Julia Debertin, MPH9, Stephanie F. Polites, MD9, David H. Rothstein, MD, MS1º, Kimberly J. Riehle, MD10, Nzuekoh Nchinda, MD10, Marcus M. Malek, MD11, Hannah N. Rinehardt, MD11, Catherine Gestrich, DO12, Shannon L. Castle, MD13, Adriana Lopez, BS14, Matthew S. Mayes, BS14, Emily K. Myers, MD15, Jonathan P. Roach, MD15, Brian T. Craig, MD16, Dave R. Lal, MD, MPH16, Jennifer Schuh, MD16, Barrett P. Cromeens, DO, PhD17, Sindhu V. Mannava, MD MS17, Mary T. Austin, MD, MPH18, Lauren K. Mayon, PA18, Zachary J. Kastenberg, MD19, Marshall Wallace, MD19, Abigail Alexander, MD19, Michael A. Stellon, MD20, Hau D. Le, MD20, Devashish S. Joshi, MD20, Charbel Chidiac, MD21, Daniel S. Rhee, MD21, Danielle Cameron, MD, MPH22, Alyssa Stetson, MD22, Barrie S. Rich, MD23, Richard D. Glick, MD23, Elizabeth A. Fialkowski, MD24, Kathryn Fowler, MD24, Rukaya Fareh, BSN24, Erin G. Brown, MD25, Kathleen Doyle, MD26, Paige Abril, BA26, Christa Grant, MD27, Roshni Dasgupta, MD, MPH28, Chloé Boehmer, MA28, and Sara A. Mansfield, MD, MS2
1Center for Surgical Outcomes and Research, Abigail Wexner Research Institute, Division of Pediatric Surgery, Department of Surgery, Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus, OH; 2Division of Pediatric Surgery, Department of Surgery, Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus, OH; 3Department of Biomedical Informatics, The Ohio State University, Columbus, OH; 4Department of Surgery, St. Jude Children’s Research Hospital, Memphis, TN; 5C.S. Mott Children’s Hospital, University of Michigan, Ann Arbor, MI; ‘General, Thoracic and Fetal Surgery, Children’s Hospital of Philadelphia, Philadelphia, PA; 7Department of Surgery, Division of Pediatric Surgery, Lurie Children’s Hospital, Northwestern School of Medicine, Chicago, IL; 8Division of Pediatric Surgery, Centre Hospitalier Universitaire Ste-Justine, Université de Montréal, Montreal, QC, Canada; 9Department of Surgery, Mayo Clinic, Rochester, MN; 10Seattle Children’s Hospital, University of Washington, Seattle, WA; 11Division of Pediatric General and Thoracic Surgery, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA; 12Division of Pathology, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA; 13Division of Pediatric Surgery, Valley Children’s Hospital, Madera, CA; 14Valley Children’s Hospital, Madera, CA; 15Division of Pediatric Surgery, Department of Surgery, University of Colorado School of Medicine, Children’s Hospital of Colorado, Aurora, CO; 16Division of Pediatric Surgery, Medical College of Wisconsin, Children’s Wisconsin, Milwaukee, WI; 17Division of Pediatric Surgery, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN; 18University of Texas, MD Anderson Cancer Center, Houston, TX; 19Department of Surgery, Division of Pediatric Surgery, University of Utah, Primary Children’s Hospital, Salt Lake City, UT ; 20Division of Pediatric Surgery, American Family Children’s Hospital, School of Medicine and Public Health, University of Wisconsin, Madison, WI; 21Division of Pediatric Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD; 22Massachusetts General Hospital, Boston, MA; 23Feinstein/Northwell, Cohen Children’s Medical Center, Queens, NY; 24Department of Surgery,
@ Society of Surgical Oncology 2025
Published online: 21 December 2025
Oregon Health & Science University, Portland, OR; 25Division of Pediatric Surgery, Department of Surgery, University of California Davis Children’s Hospital, Sacramento, CA; 26Department of Surgery, University of California Davis, Sacramento, CA; 27New York Medical College, Valhalla, NY; 28Division of Pediatric Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
This multi-institutional study evaluates contemporary outcomes of adrenal cortical carcinoma in pediatric patients across North America using data from the Pediatric Surgi- cal Oncology Research Collaborative. It provides a nuanced understanding of pediatric ACC by integrating a large cohort with existing literature, supporting cautious use of minimally
invasive surgery in select cases, emphasizing the importance of early detection, and highlighting the need for novel treat- ment strategies in metastatic disease. The findings lay the groundwork for future collaborative research and updated clinical guidelines to improve care for this rare and complex malignancy (https://doi.org/10.1245/s10434-025-18731-6).
Surgical Management and Outcomes in Pediatric Adrenocortical Carcinoma: A Pediatric Surgical Oncology Research Collaborative Study
Study Design
Results
Conclusions
Retrospective multi-institutional study across 21 institutions participating in PSORC
At diagnosis: 27% were Stage 1 17% were Stage 2 18% were Stage 3 38% were Stage 4
Pediatric ACC management across PSORC institutions revealed safe use of minimally invasive surgery in select cases and confirmed that early-stage disease is strongly associated with improved survival, while metastatic burden remains a major driver of poor outcomes
Children aged 18 years or younger
Minimally invasive surgery was used in 17% of cases for significantly smaller tumors than in open cases
Data collected from years 2012-2022
5-year OS for the entire cohort was 65.9% and 5-year EFS was 54.1% Patients without metastases had significantly better survival than those with >5 metastatic lesions
Analyzed survival outcomes stratified by age, metastatic burden and surgical approach
Our findings lay the groundwork for future efforts and for updated clinical guidelines that balance surgical innovation with oncologic prudence in the treatment of pediatric ACC
Srivatsa, et al. Ann Surg Oncol. Visual Abstract by @ShachiSrivatsa for @AnnSurgOncol
ANNALS OF SURGICAL ONCOLOGY
FUNDING None.
ARTIFICIAL INTELLIGENCE Generative artificial intelligence- assisted technologies were not used in the writing process.
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