“…In recent years, the concept of lymphadenectomy (LND) in ACC has gained greater interest and in cases of suspected or proven ACC, LND during primary surgery now appears to be a guideline-compliant procedure [ 7 , 8 , 16 ]. However, published results regarding LND in ACC are conflicting [ 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ], so its prognostic and therapeutic significance remains to be established. Further, published series usually include a limited number of patients and the reported lymphadenectomy rate within such series is low [ 4 , 18 , 21 , 23 ].…”