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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.
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.
Shares Mitotane, Localised adrenocortical carcinoma (ENSAT stage I to III, resectable), Advanced and metastatic adrenocortical carcinoma (ENSAT stage IV or unresectable).
Shares Mitotane, Advanced and metastatic adrenocortical carcinoma (ENSAT stage IV or unresectable).
Shares Mitotane, Localised adrenocortical carcinoma (ENSAT stage I to III, resectable).
Shares Mitotane, Localised adrenocortical carcinoma (ENSAT stage I to III, resectable).
Shares Mitotane, Localised adrenocortical carcinoma (ENSAT stage I to III, resectable).
Shares Mitotane, Localised adrenocortical carcinoma (ENSAT stage I to III, resectable), Advanced and metastatic adrenocortical carcinoma (ENSAT stage IV or unresectable).