Adrenocortical carcinoma natural history

Prognosis
ACC, generally, carries a poor prognosis and is unlike most tumours of the adrenal cortex, which are benign (adenomas) and only occasionally cause Cushing's syndrome. Five-year disease-free survival for a complete resection of a stage I-III ACC is approximately 30%. The most important prognostic factors are:
 * 1) Age of the patient.
 * 2) Stage of the tumor.

Poor prognostic factors:
 * 1) Mitotic activity.
 * 2) Venous invasion.
 * 3) Weight more than 50 Kg.
 * 4) Diameter more than 6.5 cm.
 * 5) Ki-67/MIB1 labeling index.