Freire et al reported a prognostic score for adrenal cortical carcinoma. This can help to identify a patient at risk for metastases and local recurrence. The authors are from Universidade de Sao Paulo.
Patient selection: adrenal cortical carcinoma, after resection
Outcome: local recurrence or metastases
Parameters:
(1) diameter in centimeters
(2) T stage
(3) mitotic index per 50 high power field (hpf)
(4) venous invasion
(5) functional activity
|
Parameter
|
Finding
|
beta coefficient
|
Points
|
|
diameter in cm
|
<= 7.5 cm
|
0
|
0
|
|
|
> 7.5 cm
|
2.784
|
28
|
|
T stage
|
T1 or T2
|
0
|
0
|
|
|
T3 or T4
|
2.617
|
26
|
|
mitotic index
|
<= 5 per 50 hpf
|
0
|
0
|
|
|
> 5 per 50 hpf
|
1.878
|
19
|
|
venous invasion
|
absent
|
0
|
0
|
|
|
present
|
1.993
|
20
|
|
functional activity
|
androgens only
|
3.81
|
38
|
|
|
other
|
0
|
0
|
where:
• The points assigned are 10 times the beta-coefficient with rounding.
X =
= SUM(beta-coefficients) - 7.7747
probability of poor outcome =
= 1 / (1 + EXP((-1) * X))
total score =
= SUM(points for all 5 parameters)
Interpretation of score:
• minimum score: 0
• maximum score: 131
• The best prognosis is seen in patients < 15 years of age at diagnosis with a score <= 77.
• The worst prognosis is for a patient >= 15 years of age at diagnosis with a score > 77.
Performance:
• The area under the ROC curve is reported as 0.96.
