Abstract
WethankBerrutietal fortheircorrespondence.Werecommended that adjuvant mitotane therapy be used only in patients with a high likelihoodofrecurrence—that is,patientswith largetumorswithmanyof the features that comprise the Weiss score and small or questionable surgical margins. The panel’s recommendation cited in the correspondence states that mitotane should be offered to patients with potential residual disease (R1 or Rx resection) and/or Ki67 more than 10%. We would agree with the panel’s recommendation, considering that it is similar to our suggestion, although we place less emphasis on Ki67, choosing instead to take a more comprehensive view. Receiving treatment with mitotane also depends on the patient’s preference and the patient’s tolerability of this difficult therapy; however, ensuring careful, frequent follow-up to detect a local recurrence as early as possible is essential. Irina Veytsman Washington Hospital Center, Washington, DC
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