Clinicopathological description of 43 oncocytic adrenocortical tumors: importance of Ki-67 in histoprognostic evaluation
2 ITX - ITX - unité de recherche de l'institut du thorax
3 CIC Nantes - Centre d’Investigation Clinique de Nantes
4 Département de biologie et pathologie médicales [Gustave Roussy]
5 Service de pathologie [CHU Lille]
6 JPArc - Centre de Recherche Jean-Pierre AUBERT Neurosciences et Cancer - U837
7 SIRIC-ONCOLille - Site de Recherche Intégrée en Cancérologie
8 Laboratoire d’anatomie et cytologie pathologique, Hôpital Robert Debré, CHU de Reims
9 CHU Tenon [AP-HP]
10 Département de Gastroentérologie et hépatologie
11 CHU - Centre Hospitalier Universitaire [Grenoble]
12 UP4 - Université Paris-Sorbonne
13 Service d'HYPERVASC [CHU HEGP)
14 Service d'Endocrinologie
15 UGA UFRM - Université Grenoble Alpes - UFR Médecine
16 Service d'endocrinologie-diabétologie-nutrition [CHU Grenoble-Alpes]
17 Service d’endocrinologie, diabétologie et maladies métaboliques [CHRU LIlle]
18 Département d'endocrinologie - Bordeaux 2
19 TOURS - Endocrino - Service d'Endocrinologie
20 MITOVASC - MitoVasc - Physiopathologie Cardiovasculaire et Mitochondriale
21 Service Endocrinologie, maladies métaboliques et nutrition [CHU Toulouse]
22 CHLS - Centre Hospitalier Lyon Sud [CHU - HCL]
23 Service de Chirurgie Générale et Endocrinienne [Lyon]
24 HESPER - Health Service and Performance Research
25 Service de chirurgie générale et endocrinienne
26 Service de Chirurgie Digestive et Endocrinienne [Nantes]
27 Médecine nucléaire
28 Hôpital Cochin [AP-HP]
29 IC UM3 (UMR 8104 / U1016) - Institut Cochin
30 UPD5 - Université Paris Descartes - Paris 5
31 Service d'Endocrinologie [Nantes]
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Résumé
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 nationwide multicenter retrospective clinicopathologic study of oncocytic adrenocortical tumors. Among the 43 patients in our cohort, 40 patients were alive without disease, 2 patients died of their disease and 1 patient was alive with relapse after a median follow-up of 38 months (20-59). Our data revealed that over 50% of the oncocytic adrenocortical tumor cases were diagnosed as carcinoma whatever the classification systems used, including the Lin-Weiss-Bisceglia score. The exception is the Helsinki score, which incorporates the Ki-67 proliferation index and was the most specific prognostic score for oncocytic adrenocortical tumor malignancy without showing a loss in sensitivity. A comparison of malignant oncocytic adrenocortical tumors with conventional adrenocortical carcinomas matched for age, sex, ENS@T stage and surgical resection status showed significant better overall survival of malignant oncocytic adrenocortical tumors.