title: The prognostic value of two different histopathological scoring systems for adrenocortical carcinomas.
abstract: OBJECTIVE
  To compare two different multiparameter histopathological scoring indices and determine their prognostic value in patients presenting with adrenocortical carcinoma (ACC).
  
  
  RESULTS
  Seventy-nine adrenal cortical tumours were divided into adenomas (n = 17), non-metastatic carcinomas (n = 24) and carcinomas with metastatic disease and/or local recurrence during follow-up (n = 19) or at time of presentation (n = 19). All cases were scored according to the Weiss revisited index (WRI) and the Van Slooten index (VSI). Both scoring indices yielded a significantly different score (P < 0.005) between adenomas and carcinomas. Non-metastasized carcinomas had a lower score with both indices compared with carcinomas with metastases at the time of presentation (VSI, P = 0.017; WRI, P = 0.019). The VSI also distinguished ACC that had metastasized at any time from those that had not (P = 0.015). Cancer-specific survival in patients with metastasized ACC correlated with the scores for both indices (VSI, P = 0.0078; WRI, P = 0.0025). Time from diagnosis of ACC to development of metastatic disease was correlated with the WRI (P = 0.036, r = -0.350).
  
  
  CONCLUSIONS
  The VSI and the WRI have equal validity in the correct categorization of ACC and adenomas. Furthermore, both indices show a correlation with survival for metastasizing ACC.
authors.affiliation: Department of Surgery, Josephine Nefkens Institute, Erasmus MC-University Medical Centre, Rotterdam, The Netherlands.
authors.forename: H P
authors.initials: HP
authors.lastname: van't Sant
authors.forename: N D
authors.initials: ND
authors.lastname: Bouvy
authors.forename: G
authors.initials: G
authors.lastname: Kazemier
authors.forename: H J
authors.initials: HJ
authors.lastname: Bonjer
authors.forename: W C J
authors.initials: WC
authors.lastname: Hop
authors.forename: R A
authors.initials: RA
authors.lastname: Feelders
authors.forename: W W
authors.initials: WW
authors.lastname: de Herder
authors.forename: R R
authors.initials: RR
authors.lastname: de Krijger
mesh_terms: D000236:Adenoma / Q000473:pathology; D000293:Adolescent; D000306:Adrenal Cortex Neoplasms / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000473:pathology / Q000556:secondary; D003937:Diagnosis, Differential; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D011379:Prognosis