Editing Pediatrics: Renal and Adrenal Oncology (section)

=== Prognosis ===
* '''Adverse prognostic factors (7): SSANDS-1'''
** '''Clinical Variables'''
**# '''Stage''': powerful independent prognostic indicator
**# '''Site of origin: adrenal primary'''
**# '''Age > 1;''' may be attributed to more unfavorable biologic parameters in tumors diagnosed at this age
** '''Biologic Variables'''
**# '''Amplification of the MYCN oncogene''' (20-25% of primary tumors)
**#* Present in 40% of patients with advanced-stage disease but in only 5-10% of children with low-stage disease
**#* Associated with rapid tumor progression and poor outcome
**# '''DNA index:''' normal or tetraploid DNA number when compared with tumors that have '''aneuploidy of the tumor DNA'''
**# '''Shimada histopathology (stroma rich vs. poor, mitotic rate, differentiation)'''
**# '''Deletion of the short arm of chromosome 1'''p