The prognostic value of two different histopathological scoring systems for adrenocortical carcinomas.
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.
van't Sant
H P
HP
Department of Surgery, Josephine Nefkens Institute, Erasmus MC-University Medical Centre, Rotterdam, The Netherlands.
Bouvy
N D
ND
Kazemier
G
G
Bonjer
H J
HJ
Hop
W C J
WC
Feelders
R A
RA
de Herder
W W
WW
de Krijger
R R
RR
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