Boileve A, Mathy E, Roux C, et al. - Combination of mitotane and locoregional treatments (LRT) is recommended in first-line by European and French guidelines for ENSAT stage IV low tumor burden or indolent adrenocortical carcinoma (ACC). Researchers sought to evaluate the benefit of LRT combination with mitotane in this selected group of patients via performing a retrospective chart review of patients with stage IV ACC with ≤ 2 tumoral organs who received mitotane. They included a total of 79 patients; 48 of these patients (61%) were female and their median age at stage IVA diagnosis was 49.8 years. Lungs (76%) and liver (48%) are the main metastatic sites. LRT was provided in 58 (73%) patients, which included adrenal bed radiotherapy (14 patients, 18%), surgery (37 patients, 47%) and/or interventional radiology n(35,44%). In support of European and French guidelines for stage IV ACC with ≤ 2 tumor-organs, the outcomes favor the combination of mitotane and LRT as first-line treatment. A significant number of complete responses were observed for the first time in this work.