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A systematic search of MEDLINE, SCOPUS, Web of Science, and the Cochrane Library for studies from 1994 to 2020 about pediatric ACT was performed. In 42 studies, 1006 patients, aged 0\u201018\u00a0years, were included. The meta\u2010analyses resulted in the following predictors of better outcome: age &lt;4\u00a0years (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.00001), nonsecreting tumors (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.004), complete surgical resection (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.00001), tumor volume (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.0001), tumor weight (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.00001), tumor maximum diameter (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.0009), and Stage I disease (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.00001). Moreover, patients affected by Cushing syndrome showed a worse outcome (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.0001). International prospective studies should be implemented to standardize clinical prognostic factors evaluation, together with pathological scores, in the stratification of pediatric ACT.<\/jats:p>","DOI":"10.1002\/pbc.28836","type":"journal-article","created":{"date-parts":[[2020,12,11]],"date-time":"2020-12-11T14:40:16Z","timestamp":1607697616000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Clinical prognostic factors in pediatric adrenocortical tumors: A meta\u2010analysis"],"prefix":"10.1002","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9610-1708","authenticated-orcid":false,"given":"Elisa","family":"Zambaiti","sequence":"first","affiliation":[{"name":"Department of Women's and Children's Health University Hospital of Padua  Padua Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Duci","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health University Hospital of Padua  Padua Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"De Corti","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health University Hospital of Padua  Padua Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piergiorgio","family":"Gamba","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health University Hospital of Padua  Padua Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3822-3272","authenticated-orcid":false,"given":"Patrizia","family":"Dall'Igna","sequence":"additional","affiliation":[{"name":"Department of Emergencies and Organ Transplantation Azienda Ospedaliero\u2010Universitaria Consorziale Ospedale Pediatrico Giovanni XXIII  Bari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Ghidini","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health University Hospital of Padua  Padua Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3651-9416","authenticated-orcid":false,"given":"Calogero","family":"Virgone","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health University Hospital of Padua  Padua Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,12,11]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mce.2011.10.015"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2004.08.085"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-200307000-00017"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.2350\/08-06-0489.1"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2014.03.006"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-200307000-00001"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41379-018-0174-8"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.26368"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2015.10.039"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1797.2010.01380.x"},{"key":"e_1_2_10_12_1","unstructured":"NHS Centre for Reviews and Dissemination.Systematic Reviews. 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