For a completely resected high risk adrenal cortical carcinoma with a high mitotic rate, what is your approach to adjuvant therapy?  

I do not ROUTINELY use adjuvant therapy for completely resected adrenal carcinoma. I think that the quality of surgery is more important, and generally am more comfortable if this has been undertaken by an experienced urologist or endocrine cancer surgeon who has achieved R0 status (full pathologica...