TY  - JOUR
T1  - PAthologic features of prognostic significance for adrenocortical carcinoma after curative resection
AU  - Harrison LE, Gaudin PB, Brennan MF
Y1  - 1999/02/01
N1  - 10.1001/archsurg.134.2.181
JO  - Archives of Surgery
SP  - 181
EP  - 185
VL  - 134
IS  - 2
N2  - Objective 
    To identify the pathologic features of prognostic significance in patients with resectable adrenocortical carcinomas.Design 
    Retrospective review.Setting 
    Tertiary referral center.Patients 
    Review of the Memorial Sloan-Kettering Cancer Center prospective adrenocortical carcinoma database from 1986 through 1996 identified 46 patients who underwent curative adrenalectomy for primary disease. All cases were reviewed by a single pathologist and each primary tumor was characterized by 16 separate pathologic parameters.Main Outcome Measure 
    Overall survival rates in the patient population.Results 
    The 5-year overall survival rate for the entire cohort was 36% (median survival rate, 28 months). Of the pathologic factors analyzed, tumor size, number of mitotic figures, and the presence of intratumoral hemorrhage were independent prognostic factors. Patients presenting with primary tumors larger than 12 cm (n=30) had a worse outcome compared with those with smaller tumors (n=16) (5-year survival rate: 53% vs 22%, P<.05). Mitotic count (≥6 per 10 high-power fields) was a negative prognostic feature (n=15) with a 5-year survival rate of 13% vs 51% for 0 to 6 mitotic figures per 10 high-power fields (n=31, P<.05). Intratumoral hemorrhage (n=23) was also a negative prognostic factor compared with no evidence of intratumoral hemorrhage (n=23) (5-year survival rate, 53% vs 22%, P<.05). Overall survival rates were also calculated based on the number of pathologic risk factors. Patients with no risk factors had an 83% 5-year survival rate, which decreased to 42% with 1 factor, 33% with 2 factors, and 0% with all 3 risk factors.Conclusions 
    Tumor size, hemorrhage, and mitotic count correlate with survival rates for patients undergoing curative resection. Based on these pathologic factors, adrenocortical carcinomas may be divided into low- and high-risk groups.
SN  - 0004-0010
M3  - doi: 10.1001/archsurg.134.2.181
UR  - http://dx.doi.org/10.1001/archsurg.134.2.181
ER  -