{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T16:04:42Z","timestamp":1790611482231,"version":"4.1.0"},"reference-count":34,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2013,3,27]],"date-time":"2013-03-27T00:00:00Z","timestamp":1364342400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2013,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To develop and internally validate a prognostic score to predict the risk of metastases or recurrence in patients with adrenal cortical carcinomas (<jats:styled-content style=\"fixed-case\">ACC<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Clinical, laboratory and pathological data from 129 <jats:styled-content style=\"fixed-case\">ACC<\/jats:styled-content> patients, treated in a tertiary centre, were retrospectively reviewed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Using a multivariate binary logistic regression analysis, we developed a prognostic score with five covariates: a functional pattern other than isolated hyperandrogenism, a tumour size &gt;7\u00b75\u00a0cm, a primary tumour classified as T3\/T4, the presence of microscopic venous invasion and a mitotic index &gt;5\/50 high\u2010power fields. The prognostic score was calibrated according to the Hosmer\u2010Lemeshow goodness\u2010of\u2010fit test (<jats:italic>P<\/jats:italic>\u00a0=\u00a00\u00b79329) and exhibited excellent overall performance (Brier score\u00a0=\u00a00\u00b70738). Finally, the discriminatory ability of the model, determined by the area under the <jats:styled-content style=\"fixed-case\">ROC<\/jats:styled-content> curve (<jats:styled-content style=\"fixed-case\">A<jats:sub>ROC<\/jats:sub><\/jats:styled-content>), was near perfect (<jats:styled-content style=\"fixed-case\">A<jats:sub>ROC<\/jats:sub><\/jats:styled-content>, 0\u00b79611; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 0\u00b792676\u20130\u00b799552). The prediction model was internally validated with 200 bootstrap resamples and achieved excellent performance for estimating the risk of metastasis and recurrence in eight additional patients with apparently localized disease at diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We developed and internally validated a prognostic score based on the clinicopathological data that are readily available to any attending physician. Our model can be used to accurately estimate the risk of unfavourable outcomes in <jats:styled-content style=\"fixed-case\">ACC<\/jats:styled-content> patients. This score could be beneficial for both patient counselling and the identification of patients in whom adjuvant mitotane is justified.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.12174","type":"journal-article","created":{"date-parts":[[2013,2,27]],"date-time":"2013-02-27T15:05:55Z","timestamp":1361977555000},"page":"468-475","source":"Crossref","is-referenced-by-count":24,"title":["Development and internal validation of an adrenal cortical carcinoma prognostic score for predicting the risk of metastasis and local recurrence"],"prefix":"10.1111","volume":"79","author":[{"given":"Daniel Soares","family":"Freire","sequence":"first","affiliation":[{"name":"Servi\u00e7o de Endocrinologia do Hospital das Cl\u00ednicas da Faculdade de Medicina da Universidade de S\u00e3o Paulo Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheila Aparecida Coelho","family":"Siqueira","sequence":"additional","affiliation":[{"name":"Divis\u00e3o de Anatomia Patol\u00f3gica do 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