Adjuvant Therapy in Resected Adrenocortical Carcinoma: Current Evidence and Patient Selection

Adrenocortical carcinoma (ACC) is a rare and aggressive malignancy with recurrence rates of 54–70% following curative-intent resection, even after microscopically complete (R0) surgery. In this review, we summarize the current evidence for adjuvant mitotane, platinum-based chemotherapy, and radiation therapy in resected ACC, and discuss patient selection based on prognostic risk stratification. We also highlight the importance of multidisciplinary management at expert centers, remaining evidence gaps, and future directions including biomarker-driven treatment strategies.