Adrenocortical tumors: results of treatment and study of Weiss's score as a prognostic factor

Abstract

PURPOSE:The differential diagnosis between benign and malignant adrenal cortical tumors circumscribed to the gland is controversial. One hundred and seven patients with adrenal cortex tumors (excluding those with primary hyperaldosteronism) were studied to assess the 5-year survival rate of adults, children, patients stratified by pathological stage, and patients stratified according to Weiss's score of <3 or >3.METHODS: The patients were evaluated both clinically and biochemically. One hundred and five patients underwent surgery and were classified pathologically as stages I, II, III, or IV. The tumors were weighed, measured, and classified according to Weiss's criteria and divided into 2 groups: <3 and >3.RESULTS: After 5 years, the survival rate was 77.5% for the whole group, 74.61% for the adults, 84.3% for the children, 100% for stage I, 83.9% for stage II, 33% for stage III, and 11.7% for stage IV groups. Additionally, after 5 years, 100% of the patients with tumors with Weiss's score <3 were alive compared to 61.65% of those with Weiss's score >3. The average weights of the tumors of score <3 and >3 were 23.38 g + 41.36 g and 376.3 + 538.76 g, respectively, which is a statistically significant difference. The average sizes of tumors of Weiss's score <3 and >3 were 3.67 + 2.2 cm and 9.64 + 5.8 cm, respectively, which is also a statistically significant difference.CONCLUSIONS: Weiss's score may be a good prognostic factor for tumors of the adrenal cortex. Additionally, there was a statistically significant difference between the average weight and size of tumors with benign behavior (Weiss's score <3) and those with malignant behavior (Weiss's score >3).

The Weiss system for evaluating adrenocortical neoplasms: 25 years later

“…In a study of 87 adrenocortical neoplasms, distant metastasis or local recurrence was observed in 91% of tumors exhibiting 3 or more histologic criteria of the Weiss system, whereas all patients with tumors showing less than 3 criteria remained free of disease [7]. A correlation between the Weiss system and clinical outcome was also shown by Lucon et al [17]. In their study, the 5-year survival of patients with tumors characterized by 3 or fewer parameters of the Weiss system was 100% as compared to a survival rate of 62% in patients with tumors displaying greater than 3 criteria.…”

“…Application of the Weiss system has also been shown to be highly reproducible with excellent interobserver agreement [16]. The effectiveness of the Weiss system in separating benign from malignant adrenocortical tumors has been validated by other investigators [10,16,17]. Among 49 adrenocortical tumors, Aubert et al [16] observed that the presence of 3 or more of the Weiss criteria correctly correlated with clinical outcome in 98% of the cases and was significant for malignancy with 100% sensitivity and 96% specificity.…”

Clinical features, outcome and prognostic factors in dogs diagnosed with non‐cortisol‐secreting adrenal tumours without adrenalectomy: 20 cases (1994–2009)

“…The latest two factors have also been described in human beings (Lucon and others 2002) and in dogs (Massari and others 2011). The latest study found that dogs with a major axis length of the adrenal mass ≥50 mm were associated with 85 per cent shorter survival time.…”

Pediatric Genitourinary Oncology

“…Histologic differentiation of ACT in children is more difficult to define than in adults (72, 73). The prognosis is good in young patients with completely removed, non-metastatic, and non-infiltrative lesions.…”