Table S1. Association of clinical, histopathological and immunohistopathological markers with prognostic factors
CharacteristicsStage 1-2Stage 3-4p-valueNo Metastases at diagnosisMetastases at diagnosisp-value
Clinical
-Size9 (4-12)12(1-24)0.1079(1-24)13.2(9.5- 17)0.039
-Functionality [n (%)]7 (53.9)8(72.7)0.4232(15.4)3(27.3)0.630
Histopathological
-Weiss [median (min-max)]5(4-8)7(6-9)0.0056(4-8)6(6-9)0.414
Helsinki [median (min-max)]24(10-38)33(20-56)0.09630(10-56)25.5(23-48)0.788
-Capsular invasion [n (%)]5(55.6)14(93.3)0.04714(73.7)5(100)0.544
-Vascular invasion [n (%)]3(33.3)8(53.3)0.4237(36.8)4(80)0.142
-Nuclear atypia [n (%)]8(88.9)15(100)0.37518(94.7)5(100)0.999
-Mitoses >20 per 50HPF [n (%)]2(22.2)9(60)0.1058(42.1)3(60)0.630
Reticulin [score 4, n (%)]3(37.5)6(60)0.6377(50)2(50)0.999
Immunohistopathological [median (min-max)]
-Ki-67%17(15-30)30(15-45)0.09522 (15-45)30(15-40)0.611
-p27 [IRS]12(4-12)12(9-12)0.56512(4-12)9(9-12)0.756
-p53 [pathological, n (%)]7(87.5)8(88.9)0.99911(84.6)4(100)0.999
-P53(WT/overexpression 21-1(12.5)/5(62.1(11.1)/3(30.4202(15.4)/8(61.0(0)/0(0)/4(0.035
50%/≥50%, n(%))5)/2(25)3.3)/5(55.6)5)/3(23.1)100)

Abbreviations: ACC; Adrenal cortical carcinoma, HPF; High-power fields, IRS; Immunoreactive score, WT; Wild type

Table S2. Univariate Cox Regression Analysis for Risk Factors Associated with PFS and OS in 24 Patients with ACC
PFSOS
Hazard Ratiop-valueHazard Ratiop-value
Clinical characteristics
Age (years)1.040.1541.020.558
Sex (Women)0.380.1490.510.407
Size (mm)1.040.3301.020.748
Functionality7.020.0035.220.046
Metastatic presentation1.810.3332.870.152
Histopathological characteristics
Weiss (≥6)6.340.078--
Helsinki1.020.3371.020.499
Stage (3 or 4)3.810.0473.230.155
Reticulin score0.880.8620.840.837
Immunohistochemical characteristics
Ki-67%1.030.3521.020.576
Capsular invasion3.620.2171.960.527
Vascular invasion1.610.3962.070.317
Mitoses >20 per 50 HPF2.480.1131.420.619
Atypical mitoses1.280.750--
P27 (IRS)0.810.1400.900.447
P53 (pathological)1.390.757--
P53 (WT/ overexpession 20- 49% vs. >50%)*3.990.032--

*as continuous variable

Abbreviations: PFS; Progression free survival, OS; Overall survival, ACC; Adrenal cortical carcinoma, HPF; High-power fields, IRS; Immunoreactive score, WT; Wild type

Figure S1. Kalpan Meier curve for PFS of patients with ACC

1.00

0.75

PFS probability

0.50

0.25

0.00

0

25

50

75

100

Time to Relapse (months)

Number at risk

Strata

All

24

7

2

1

1

0

25

50

75

100

Time to Relapse (months)

Figure S2. Kalpan Meier curve for OS of patients with ACC

1.00

Survival probability

0.75

0.50

0.25

0.00

0

25

50

75

100

Time to Death (months)

Number at risk

Strata

All

24

10

1

1

1

0

25

50

75

100

Time to Death (months)