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Invited Critique
February 1999

Invited Critique: Pathologic Features of Prognostic Significance for Adrenocortical Carcinoma After Curative Resection

Arch Surg. 1999;134(2):185. doi:10.1001/archsurg.134.2.185

Harrison et al have built on Brennan's long-standing interest in adrenocortical carcinoma, using the Memorial Sloan-Kettering Cancer Center's extensive experience and detailed database to compile a unique report. This series correlates histologic features of resected tumors with clinical outcome, but only in patients undergoing curative surgery. As they properly point out, other investigators have made the same correlation, but not in reports restricted to patients treated with curative surgery. Series "contaminated" by patients undergoing palliative surgery who received adjuvant therapy may obscure more subtle findings that should more properly influence the use of adjuvant therapy. Some may argue that the issue is moot without effective adjuvant agents. Although mitotane has been almost uniformly disappointing, there is hope that taxanes may be effective.

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