Gaujoux and Mihai listed findings associated with recurrence of an adrenocortical adenocarcinoma after surgery. These findings can help to identify a patient who may benefit from closer monitoring. The study was conducted by the European Society of Endocrine Surgeons (ESES) and European Network for the Study of Adrenal Tumors (ENSAT).
Patient selection: adrenocortical adenocarcinoma following surgical resection, Stages 1 to 3. Stage 4 (distant metastates) not amenable to curative surgical resection.
Stage 3 from the ENSAT criteria - one or more of the following:
(1) positive lymph node(s)
(2) extra-adrenal tissue infiltration
(3) venous tumor thrombus
Parameters:
(1) stage
(2) R status of resection (R0, R1, R2)
(3) N status for lymph nodes (from TNM)
(4) Ki-67 staining in percent
Moderate risk of recurrence - all of the following:
(1) Stage 1 or 2
(2) R0 resection
(3) N0
(4) Ki-67 staining < 10%
"Intermediate" risk (moerate to high) - all of the following:
(1) Stage 3
(2) R0 resection
(3) N0
(4) Ki-67 staining < 10%
High risk - one or more of the following:
(1) R1 or R2 resection
(2) N1
(3) Ki-67 >= 10%
(4) tumor spillage during the procedure
