Data set for reporting of carcinoma of the adrenal cortex: explanations and recommendations of the guidelines from the International Collaboration on Cancer Reporting

Published on Apr 1, 2021in Human Pathology2.735
· DOI :10.1016/J.HUMPATH.2020.10.001
Thomas J. Giordano95
Estimated H-index: 95
(UM: University of Michigan),
Daniel M. Berney66
Estimated H-index: 66
(Barts Health NHS Trust)
+ 9 AuthorsAnthony J. Gill73
Estimated H-index: 73
(Kolling Institute of Medical Research)
Summay Complete resection of adrenal cortical carcinoma (ACC) with or without adjuvant therapy offers the best outcome. Recurrence is common, and in individual cases, the long-term outcome is difficult to predict, making it challenging to personalize treatment options. Current risk stratification approaches are based on clinical and conventional surgical pathology assessment. Rigorous and uniform pathological assessment may improve care for individual patients and facilitate multi-institutional collaborative studies. The International Collaboration on Cancer Reporting (ICCR) convened an expert panel to review ACC pathology reporting. Consensus recommendations were made based on the most recent literature and expert opinion. The data set comprises 23 core (required) items. The core pathological features include the following: diagnosis as per the current World Health Organization classification, specimen integrity, greatest dimension, weight, extent of invasion, architecture, percentage of lipid-rich cells, capsular invasion, lymphatic invasion, vascular invasion, atypical mitotic figures, coagulative necrosis, nuclear grade, mitotic count, Ki-67 proliferative index, margin status, lymph node status, and pathological stage. Tumors were dichotomized into low-grade ( 20 mitoses per 10 mm2) ones. Additional noncore elements that may be useful in individual cases included several multifactorial risk assessment systems (Weiss, modified Weiss, Lin-Weiss-Bisceglia, reticulin, Helsinki, and Armed Forces Institute of Pathology scores/algorithms). This data set is now available through the ICCR website with the hope of better standardizing pathological assessment of these relatively rare but important malignancies.
#1Martin Fassnacht (University of Würzburg)H-Index: 79
#2Guillaume Assié (French Institute of Health and Medical Research)H-Index: 36
Last. Alfredo Berruti (University of Brescia)H-Index: 66
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48 CitationsSource
#1Cécile Picard (UCBL: Claude Bernard University Lyon 1)H-Index: 5
#2Daniel Orbach (Curie Institute)H-Index: 41
Last. Frédérique Dijoud (UCBL: Claude Bernard University Lyon 1)H-Index: 18
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The prognosis of malignant pediatric adrenocortical tumors is closely related to disease stage, which is used to guide perioperative treatment recommendations. However, current scoring systems are inadequate to distinguish between benign and malignant adrenocortical tumors. Robust microscopic prognostic features that could help determine perioperative therapy are also lacking. The aim of this national study was to review the prognostic value of the Wieneke scoring criteria and Ki67 labeling inde...
15 CitationsSource
#1Jason A. Glenn (UM: University of Michigan)H-Index: 1
#2Tobias Else (UM: University of Michigan)H-Index: 32
Last. Barbra S. Miller (UM: University of Michigan)H-Index: 24
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Background Patterns and prognostic implications of recurrent adrenocortical carcinoma are poorly understood. In this study, we aim to describe temporal and spatial patterns of adrenocortical carcinoma recurrence. Methods This is a retrospective review of 576 patients with adrenocortical carcinoma evaluated at a single institution. Clinicopathologic and follow-up data were collected longitudinally. Results A total of 354 patients underwent resection of stage I-III adrenocortical carcinoma. We fou...
19 CitationsSource
#1Martin Fassnacht (University of Würzburg)H-Index: 79
#2Olaf M. Dekkers (LEI: Leiden University)H-Index: 78
Last. Massimo Terzolo (UNITO: University of Turin)H-Index: 70
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Adrenocortical carcinoma (ACC) is a rare and in most cases steroid hormone-producing tumor with variable prognosis. The purpose of these guidelines is to provide clinicians with best possible evidence-based recommendations for clinical management of patients with ACC based on the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system. We predefined four main clinical questions, which we judged as particularly important for the management of ACC patients and performed sy...
240 CitationsSource
Oncocytic adrenocortical tumors are a rare subtype of adrenal tumors with challenging diagnosis and histoprognostic assessment. It is usually believed that oncocytic adrenocortical tumors have a more indolent clinical behavior than conventional adrenocortical tumors. As the Weiss score overestimates the malignancy of oncocytic adrenocortical tumors owing to intrinsic parameters, alternative scores have been proposed. The Lin–Weiss–Bisceglia score is currently recommended. We performed a large na...
12 CitationsSource
#1Ozgur Mete (UHN: University Health Network)H-Index: 35
#2Sylvia L. Asa (UHN: University Health Network)H-Index: 114
Last. Marco Volante (UNITO: University of Turin)H-Index: 71
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Careful morphological evaluation forms the basis of the workup of an adrenal cortical neoplasm. However, the adoption of immunohistochemical biomarkers has added tremendous value to enhance diagnostic accuracy. The authors provide a brief review of immunohistochemical biomarkers that have been used in the confirmation of adrenal cortical origin and in the detection of the source of functional adrenal cortical proliferations, as well as diagnostic, predictive, and prognostic biomarkers of adrenal...
18 CitationsSource
#1Ozgur Mete (UHN: University Health Network)H-Index: 35
#2Hasan Güçer (Recep Tayyip Erdoğan University)H-Index: 10
Last. Sylvia L. Asa (U of T: University of Toronto)H-Index: 114
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The diagnosis of low-grade adrenal cortical carcinoma (ACC) confined to the adrenal gland can be challenging. Although there are diagnostic and prognostic molecular tests for ACC, they remain largely unutilized. We examined the diagnostic and prognostic value of altered reticulin framework and the i
28 CitationsSource
#1김나래H-Index: 1
#2LloydH-Index: 1
Last. Kloppel GH-Index: 1
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494 Citations
Context: In 2007, a retrospective case-control study provided evidence that adjuvant mitotane prolongs recurrence-free survival (RFS) in patients with radically resected adrenocortical carcinoma (ACC). Objective and Design: We aimed to confirm the prognostic role of adjuvant mitotane in the same series after 9 additional years of follow-up. Setting, Patients, and Interventions: One hundred sixty-two ACC patients who did not recur or die after a landmark period of 3 months were considered. Forty-...
70 CitationsSource
#1Eleonora Duregon (UNITO: University of Turin)H-Index: 16
#2Rocco Cappellesso (UNIPD: University of Padua)H-Index: 22
Last. Mauro Papotti (UNITO: University of Turin)H-Index: 98
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Summary Adrenocortical carcinoma patient prognosis is extremely variable and poorly predictable. The newly introduced Helsinki Score is the first so far proposed diagnostic and prognostic system based on the combined evaluation of morphological (mitoses and necrosis) and immunohistochemical (Ki-67) parameters. The aim of the study was to validate the prognostic role of the Helsinki Score for adrenocortical carcinoma characterization. Thus, 225 adrenocortical carcinomas were reclassified using th...
46 CitationsSource
Cited By5
#1Mario Detomas (University of Würzburg)
#2Barbara Altieri (University of Würzburg)H-Index: 16
Last. Silviu Sbiera (University of Würzburg)H-Index: 24
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The occurrence of different subtypes of endogenous Cushing’s syndrome (CS) in single individuals is extremely rare. We here present the case of a female patient who was successfully cured from adrenal CS 4 years before being diagnosed with Cushing’s disease (CD). The patient was diagnosed at the age of 50 with ACTH-independent CS and a left-sided adrenal adenoma, in January 2015. After adrenalectomy and histopathological confirmation of a cortisol-producing adrenocortical adenoma, biochemical hy...
Adrenocortical carcinoma (ACC) is a rare, aggressive malignancy with an annual incidence of ~1 case per million population. Differentiating between ACC and benign adrenocortical tumors can be chall...
#1Marco VolanteH-Index: 71
#2Ida RapaH-Index: 22
Last. Mauro PapottiH-Index: 98
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The molecular mechanisms of adrenocortical carcinoma development are incompletely defined. De-regulation of cellular-to-extracellular matrix interactions and angiogenesis appear among mechanisms associated to the malignant phenotype. Our aim was to investigate, employing PCR-based array profiling, 157 molecules involved in cell-to-matrix interactions and angiogenesis in a frozen series of 6 benign and 6 malignant adrenocortical neoplasms, to identify novel pathogenetic markers. In 14 genes, a si...
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#1Alfred King-Yin Lam (Griffith University)H-Index: 59
Adrenocortical carcinoma (ACC) is a heterogenous group of diseases with different clinical behaviour between adult and paediatric patients. In addition, three histological variants, oncocytic, myxoid and sarcomatoid are noted on the recent World Health Organisation (WHO) classification of ACC. A review of recent literature showed that the different types of ACC have distinctive demographic data, clinical presentation, pathology, biological behaviour, genomic and patients' prognosis. In addition,...
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#1C. Christofer Juhlin (KI: Karolinska Institutet)H-Index: 25
#2Jérôme Bertherat (University of Paris)H-Index: 95
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Approximately one-tenth of the general population exhibit adrenal cortical nodules, and the incidence has increased. Afflicted patients display a multifaceted symptomatology-sometimes with rather spectacular features. Given the general infrequency as well as the specific clinical, histological, and molecular considerations characterizing these lesions, adrenal cortical tumors should be investigated by endocrine pathologists in high-volume tertiary centers. Even so, to distinguish specific forms ...
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