Adjuvant Therapy in Adrenocortical Carcinoma: Reflections and Future Directions

摘要: Adrenocortical carcinoma (ACC) is a rare and aggressive malignancy with high risk of recurrence despite macroscopically complete surgical resection. The main predictors ACC include advanced disease stage, incomplete resection, cortisol production, certain genetic alterations, proliferation rate (Ki-67 index). Mitotane has been the mainstay adjuvant therapy ACC. However, use mitotane based on retrospective occasionally conflicting evidence. As levels can take few months before reaching therapeutic levels, there an emerging practice combining platinum-based chemotherapy in setting. Retrospective data indicate that radiotherapy option for select patients, particularly those positive resection margins. There are multiple knowledge gaps selecting patients therapy. It great importance to establish calculators predict implement molecular profiling guide role immunotherapy metastatic if deemed efficacious, then future studies will be needed ascertain