Nuclear
deoxyribonucleic acid (
DNA) ploidy studies with use of
paraffin-embedded specimens were performed by flow cytometry on 52
adrenocortical carcinomas. Specimens were prepared by the combined techniques of Hedley and Vindeløv.
Clinical course was obtained by chart review and follow-up examination. Nine (17%)
tumors had a normal (diploid)
DNA pattern, 13 (25%) were
DNA tetraploid, and 30 (58%) were
DNA aneuploid. The
DNA aneuploid group was subdivided: 18
tumors with one stemline and 12
tumors with two stemlines of abnormal
DNA cells. For
tumors that were resected for cure, the 5-year Kaplan-Meier disease-free survival rates of the five patients with
DNA diploid
tumors and of the six patients with
DNA tetraploid tumors were 80% and 33%, respectively. For 21 patients of whom 12 had one-stemline and nine had two-stemline
DNA aneuploid tumors, the survival was 67% and 0%, respectively. Following palliative resection, the 4-year survival rates of the four patients with
DNA diploid, seven with
DNA tetraploid, five (omitting one with short follow-up) with one-stemline
DNA aneuploid, and three with two-stemline
DNA aneuploid tumors were 0%, 0%, 0%, and 33%, respectively. Although
adrenocortical carcinoma is in general markedly aggressive, the addition of nuclear
DNA ploidy studies may help to identify certain groups of patients who have a relatively favorable prognosis.