European Society of Endocrinology and ENSAT clinical practice guidelines on the management of adrenocortical carcinoma in adults
The European endocrine guideline for adrenocortical carcinoma: hormonal work-up, complete surgery by an expert, mitotane for those at high risk of relapse, and EDP-mitotane for disease that has spread.
Overview
Guideline from the European Society of Endocrinology with the European Network for the Study of Adrenal Tumors covering diagnosis and hormonal evaluation of adrenal masses, staging with the ENSAT system, open adrenalectomy in specialist centres, risk stratification by resection status and Ki-67, adjuvant mitotane and radiotherapy, mitotane monitoring, and etoposide, doxorubicin and cisplatin plus mitotane for advanced disease on the FIRM-ACT result.
It grades the evidence, which is largely retrospective, and recommends care in expert centres and enrolment in registries and trials.
The standard-of-care rows on both adrenocortical carcinoma pages, from who gets mitotane after surgery to the EDP-M regimen, follow this guideline.
- Predates ADIUVO, which found no benefit from adjuvant mitotane in the lowest-risk group.
- Most recommendations rest on retrospective series.
Similar pages
not linked directly; found by shared links- Key paperADIUVO: adjuvant mitotane versus surveillance in low-grade, localised adrenocortical carcinoma
Shares Mitotane, Localised adrenocortical carcinoma (ENSAT stage I to III, resectable).
- TermAdrenalectomy
Shares Mitotane, Localised adrenocortical carcinoma (ENSAT stage I to III, resectable), Advanced and metastatic adrenocortical carcinoma (ENSAT stage IV or unresectable).
- Key paperFIRM-ACT: combination chemotherapy in advanced adrenocortical carcinoma
Shares Mitotane, Advanced and metastatic adrenocortical carcinoma (ENSAT stage IV or unresectable).
- CancerAdrenocortical carcinoma
Shares Mitotane, Localised adrenocortical carcinoma (ENSAT stage I to III, resectable), Advanced and metastatic adrenocortical carcinoma (ENSAT stage IV or unresectable).
- TermGermline vs somatic mutations
Shares Localised adrenocortical carcinoma (ENSAT stage I to III, resectable), Advanced and metastatic adrenocortical carcinoma (ENSAT stage IV or unresectable).