Objective: Adrenocortical cancer (ACC) is one of the rareendocrine system cancers that are aggressive. Despite surgicaltreatment, the mortality rate is quite high. This studyaimed to examine prognostic factors affecting survival in patientswith ACC, the role of dehydroepiandrosterone sulfate(DHEA-S), and the maximum standard uptake (SUVmax) valueson predicting mortality through the single-center data.Material and Methods: A total of 21 patients who were diagnosedwith adrenal cancer and followed from a single centerwere included in the study. Patients who survivedfollow-ups were included in the survived group (n=6), andthose who died were included in the dead group (n=15). Thedemographic, anatomical, pathological, and clinical characteristicsof the patients were analyzed. Positron emission tomography-computerized tomography imaging and SUVmaxvalues of adrenal masses were compared. The effect of allthese data on survival was examined. Results: The mortalityrate among patients with ACC was 71%. According tothe Kaplan-Meier survival analysis, the average life expectancywas 23.66±2.79 (95% CI=18.18-29.13) months. Themass size of the survived and dead groups was 9.2±3.82cm and 10.84±4.74 cm, respectively. The production rate ofadrenal hormone was higher in the dead group (p<0.01;80%). Moreover, the DHEA-S level and SUVmax values werestatistically significantly higher in the dead group (p<0.001;p<0.05, respectively). Although no metastases were observedin the survived group during follow-ups after the operation,distant metastases were observed in 8 people from thedead group (53%; p<0.05). Conclusion: The mortality ratewas very high in ACC despite surgical and medical treatments.The higher DHEA-S and SUVmax values may indicatethat the overall survival duration was low.