Primary and adjunctive therapy in carcinoma of the adrenal cortex.

The absence of a clinically useful staging system for carcinoma of the adrenal cortex has permitted undue pessimism to develop and prevented effective evaluation of postoperative adjunctive therapy. The records of 15 patients undergoing operation for carcinoma of the adrenal gland were studied, and a staging system is proposed. The correlation between the proposed clinical stages and a patient's survival time was highly significant. An aggressive surgical approach toward both the primary tumor and the isolated metastatic lesion appears warranted. In those patients with functioning tumors, determination of urinary steroid levels provides early evidence of recurrence.