The DOI matches its Crossref record.
Pathologic Features of Prognostic Significance in Adrenocortical Carcinoma
Abstract
There are currently no well-established pathologic prognostic factors helpful in distinguishing low versus high grade adrenocortical carcinomas. The effect of 11 pathologic parameters on survival was investigated in 42 cases of adrenocortical carcinoma. Only one variable, mitotic rate, had a strong statistical association with patient outcome. The 21 patients with carcinomas with greater than 20 mitoses per 50 high power fields (hpf) had a median survival of 14 months, whereas the 21 patients with carcinomas with less than or equal to 20 mitoses had a median survival of 58 months (p less than 0.02). The presence of atypical mitoses, capsular invasion, tumor weight greater than 250 g, and size greater than 10 cm each showed a marginal statistical association with poor survival (p less than 0.06), whereas other features assessed, such as nuclear grade, presence of necrosis or of venous or sinusoidal invasion, character of the tumor cell cytoplasm, or architectural pattern, showed no statistical significance in predicting survival. It is proposed that adrenal cortical carcinomas with greater than 20 mitoses be designated high grade, whereas tumors with less than or equal to 20 mitoses be designated low grade.
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“A threshold above a Weiss score of 3 (also on the modified score) was associated with an increased risk of malignant behavior (112).”
From Adrenal incidentaloma (2020) · cites this paper as [112]
In the citing paper
“In the initial study by Weiss, the features with the strongest association to outcome were the mitotic rate >5/50 high powered field, atypical mitoses, and venous invasion (111) and in the second study by Weiss in 1989 the strongest association with patient outcome was the mitotic rate (112).”
From Adrenal incidentaloma (2020) · cites this paper as [112]
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Tumeurs sécrétantes et hyperfonctionnements surrénaliens
Meziane, Y., Othmani, W., Kabas, R., Bomba, B., Ngom, K., Morland, D., & Hoeffel, C. (2026) · EMC - Radiologie et imagerie médicale - Génito-urinaire - Gynéco-obstétricale - Mammaire · doi:10.1016/s1879-8543(25)61407-8
Génomique intégrée des tumeurs bénignes corticosurrénaliennes
Faillot, S. (2017) · theses.fr (ABES) · doi:10.70675/36869127z1fb2z41bbzb082z1048e489a8e6
Monsour, E. P., Dogra, P., Giparas, S., Westra, W. H., Voss, R. K., & Veloski, C. (2026) · JCEM Case Reports · doi:10.1210/jcemcr/luag059
Arnold, E. C., Filho, J. R. D. O., Cameron, D. B., & Mansfield, S. A. (2026) · Surgical Oncology Clinics of North America · doi:10.1016/j.soc.2026.04.013
Adrenocortical Carcinoma with Suspected Dual Cortisol and Aldosterone Secretion
Jaime, C. F., & Gan, F. R. (2026) · Journal of the ASEAN Federation of Endocrine Societies · doi:10.15605/jafes.041.02.5875
Altay, F. P., Polat, Ş. B., Fakı, S., Karaahmetli, G., Akdoğan, L., Topaloğlu, O., Ersoy, R., & Çakır, B. (2026) · Diagnostics · doi:10.3390/diagnostics16172807
“The Weiss scoring system was applied for the assessment of adrenocortical neoplasms, and a score ≥ 3 was used to define malignancy [9].”
Araya, A. V., & Espinoza, J. (2026) · IntechOpen eBooks · doi:10.5772/intechopen.1016740
Veera, S. K., Shacham, N., Epstein, J., Cohen, D. W., Román, E., Thomas, K. M., Lipton, M., & Kohn, B. (2026) · Hormone Research in Paediatrics · doi:10.1159/hrp/adaag014
Rare Tumors of the Peripheral Nervous System
Brennan, B. M. D., Galindo, C. R., & Bisogno, G. (2011) · Pediatric oncology · doi:10.1007/978-3-642-04197-6_42
Reappraisal of Adrenal ZonationTheories Based on the Differential Regulation of Apoptosis
Wolkersdörfer, G. W., & Bornstein, S. R. (2001) · Humana Press eBooks · doi:10.1007/978-1-59259-101-5_3
Molecular Pathology of Endocrine Cancer
Lloyd, R. V., Jin, L. G., Buehler, D. G., Hardin, H. A., & Shan, W. (2012) · Springer eBooks · doi:10.1007/978-1-4614-4900-3_17
Wajchenberg (2000) · doi:10.1002/(sici)1097-0142(20000215)88:4
Metadata
- Authors
- Weiss, L. M., Medeiros, L. J., & Vickery, A. L.
- Affiliations
- Stanford University (US)
- Massachusetts General Hospital (US)
- Venue
- The American Journal of Surgical Pathology
- Published
- 1989-03
- Volume
- 13
- Issue
- 3
- Pages
- 202-206
- ISSN
- 0147-5185 (ISSN-L)
- OpenAlex
- W2023370041
- Cited by
- 818
- References
- 0
- Citations by year
- 2026: 13 · 2025: 21 · 2024: 19 · 2023: 20 · 2022: 33 · 2021: 30 · 2020: 34 · 2019: 22 · 2018: 27 · 2017: 30 · 2016: 31 · 2015: 40 · 2014: 38 · 2013: 33 · 2012: 34
- FWCI
- 8.11
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Surgical Pathology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
- Health Sciences › Medicine › Oncology › Renal cell carcinoma treatment
- Health Sciences › Medicine › Oncology › Sarcoma Diagnosis and Treatment
- Keywords
- adrenocortical carcinoma, prognostic factors, mitotic activity, tumor grade, survival, capsular invasion, tumor size, tumor weight, atypical mitoses, venous invasion, nuclear grade, necrosis
- MeSH terms
- Adolescent, Adrenal Cortex Neoplasms, Adult, Aged, Carcinoma, Child, Humans, Middle Aged, Mitotic Index, Neoplasm Invasiveness, Prognosis
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