 urinari steroid estim predict respons adrenalectomi hypophysectomi clinic trial carri test discrimin assess suitabl patient advanc breast cancer hypophysectomi adrenalectomi patient posit discrimin submit hypophysectomi better prognosi patient neg discrimin submit adrenalectomi patient select adrenalectomi neg discrimin wors respons oper patient select random sampl patient select hypophysectomi posit discrimin tend better respons oper patient select random sampl differ adrenalectomi recommend patient neg discrimin 