This protocol covers the management of adrenocortical carcinoma (ACC) staged at ENSAT I, II, or III, where complete radical en bloc resection is considered feasible.
Staging at initial diagnosis follows the ENSAT (European Network for the Study of Adrenal Tumours) classification. Patients at stage I and II — and most patients at stage III — are considered candidates for radical resection. This protocol applies when complete en bloc removal is achievable.
The cornerstone of management is surgical — complete en bloc resection of the adrenal tumour. The full protocol specifies approach selection criteria, required surgical technique principles, lymph node management, and perioperative considerations.