Comment - Is there a role for low doses of mitotane (o,p '-DDD) as adjuvant therapy in adrenocortical carcinoma?

The role of mitotane as adjuvant treatment for adrenocortical carcinoma is controversial. Our experience with adjuvant mitotane, as that of others, indicates that it is not beneficial in terms of either disease freedom or survival. Owing to these disappointing results and the side-effects of mitotane, which significantly worsen quality of life of patients, we would not advocate mitotane as adjuvant treatment of adrenocortical carcinoma. However, prospective studies are needed to evaluate the real efficacy of this compound.