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Management of adjuvant mitotane therapy following resection of adrenal cancer

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Abstract

Whenever adrenal cancer (ACC) is completely removed we should face the dilemma to treat by means of adjuvant therapy or not. In our opinion, adjuvant mitotane is the preferable approach in most cases because the majority of patients following radical removal of an ACC have an elevated risk of recurrence. A better understanding of factors that influence prognosis and response to treatment will help in stratifying patients according to their probability of benefiting from adjuvant mitotane, with the aim of sparing unnecessary toxicity to patients who are likely unresponsive. However, until significant advancements take place, we have to deal with uncertainty using our best clinical judgement and personal experience in the clinical decision process. In the present paper, we present the current evidence on adjuvant mitotane treatment and describe the management strategies of patients with ACC after complete surgical resection. We acknowledge the limit that most recommendations are based on personal experience rather than solid evidence.

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Conflict of interest

There is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

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Authors and Affiliations

  1. Internal Medicine I, San Luigi Hospital, University of Turin, Regione Gonzole 10, 10043, Orbassano, Italy

    M. Terzolo, A. Ardito, B. Zaggia, F. Laino, A. Germano & F. Daffara

  2. Pharmacology, San Luigi Hospital, University of Turin, Orbassano, Italy

    S. De Francia

  3. Medical Oncology, San Luigi Hospital, University of Turin, Orbassano, Italy

    A. Berruti

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  1. M. Terzolo
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  2. A. Ardito
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  3. B. Zaggia
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Correspondence to M. Terzolo.

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Terzolo, M., Ardito, A., Zaggia, B. et al. Management of adjuvant mitotane therapy following resection of adrenal cancer. Endocrine 42, 521–525 (2012). https://doi.org/10.1007/s12020-012-9719-7

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  • DOI: https://doi.org/10.1007/s12020-012-9719-7

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