scholarly journals Adjuvant Radiotherapy for Synchronous Bilateral Testicular Seminoma: A Case Report and a Review of the Pertinent Literature

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Daniel A. Jones ◽  
Elizabeth C. Ester ◽  
David Leavitt ◽  
Robert Sweet ◽  
Badrinath Konety ◽  
...  
Keyword(s):  
Adjuvant Radiotherapy ◽  
Organ Preservation ◽  
World Literature ◽  
External Beam Radiotherapy ◽  
Germ Cell Tumors ◽  
Stage I ◽  
Testicular Seminoma ◽  
Bilateral Orchiectomy ◽  
Stage I Seminoma ◽  
Paraaortic Radiotherapy

Few cases of synchronous bilateral stage I seminomas have been reported in the world literature. We present a case of bilateral synchronous testicular seminoma, the current literature on the management of stage I seminoma, and the implications for radiotherapy. A forty-year-old man presented with synchronous bilateral classical seminomas, both stage IA. After undergoing bilateral inguinal orchiectomy, he received adjuvant external beam radiotherapy, with a standard paraaortic field. After 18 months of followup, he remains well, without evidence of recurrence. Bilateral germ cell tumors (BGCTs) are reported consistently at a low rate. Bilateral radical inguinal orchiectomy is standard of care, yet some groups have proposed an organ preservation approach. Of the reported cases of bilateral stage I synchronous GCT, with concordant seminoma histology, most of them were treated with bilateral orchiectomy and adjuvant radiotherapy. Although morbidity associated with radiotherapy directed at the abdomen is not negligible, adjuvant paraaortic radiotherapy remains safe and well-tolerated treatment regime. Bilateral synchronous stage I seminoma of the testes is rare. Organ preservation remains investigational. Chemotherapy is probably a reasonable option. We propose that patients with bilateral stage I synchronous GCT, with concordant seminoma histology, should be managed with bilateral orchiectomy, followed by paraaortic radiotherapy.

scholarly journals Late and Rapid Relapse in Mediastinum from Testicular Germ Cell Tumor Stage I Over 13 Years after Surgery

2019 ◽  
Vol 12 (2) ◽  
pp. 500-505
Author(s):  
Toshirou Fukushima ◽  
Takuro Noguchi ◽  
Takashi Kobayashi ◽  
Nodoka Sekiguchi ◽  
Takesumi Ozawa ◽  
...  
Keyword(s):  
Germ Cell ◽  
Mediastinal Lymph Node ◽  
Relevant Literature ◽  
Germ Cell Tumors ◽  
Stage I ◽  
Careful Examination ◽  
Late Relapse ◽  
Testicular Germ Cell Tumors ◽  
Testicular Germ Cell ◽  
Testicular Seminoma

Patients with stage I testicular germ cell tumors have a long life expectancy, but the tumors have a potential to relapse after treatment. Although relapse is observed within a few years in most cases, late relapse over 10 years after initial treatment has also been reported in patients with stage I testicular germ cell tumors. We encountered a case of testicular seminoma that developed mediastinal lymph node metastasis 13 years after radical surgery for the primary tumor. The relapsed disease progressed rapidly and the patient died within 1 month due to respiratory failure without any chance for therapy. On postmortem examination, the thoracic lesions were pathologically confirmed to be metastases from the testicular seminoma with yolk sac tumor. Here, we report the clinical course and a review of the relevant literature. Based on our experience, we emphasize long-term follow-up and/or careful examination in patients with stage I testicular germ cell tumors.

What is the value of routine follow-up in stage I seminoma after paraaortic radiotherapy?

2009 ◽  
Vol 185 (6) ◽  
pp. 349-354 ◽  
Author(s):  
Johannes Claßen ◽  
Heinz Schmidberger ◽  
Rainer Souchon ◽  
Lothar Weissbach ◽  
Michael Hartmann ◽  
...  
Keyword(s):  
Stage I ◽  
Stage I Seminoma ◽  
Paraaortic Radiotherapy

Surveillance for stage I testicular seminoma: Retrospective analysis of prognostic factors for relapse at a single institution in Japan

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 15630-15630
Author(s):  
K. Kakimoto ◽  
Y. Ono ◽  
N. Meguro ◽  
A. Kawashima ◽  
T. Kinouchi ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Survival Rate ◽  
Vascular Invasion ◽  
Lymphatic Invasion ◽  
Rete Testis ◽  
Stage I ◽  
Single Institution ◽  
Testicular Seminoma ◽  
Beta Hcg ◽  
Stage I Seminoma

15630 Background: Treatment options for clinical stage I seminoma include adjuvant radiotherapy (RT) as well as surveillance and adjuvant chemotherapy. Although adjuvant RT remains the treatment of choice in most centers, the success of surveillance of patients with stage I nonseminomatous germ cell tumors and the establishment of curative chemotherapy for advanced disease have led to re-examination of the standard treatment approach. Data available from the surveillance and adjuvant RT series suggest that nearly 100% of patients with stage I testicular seminoma are cured, whichever approach is chosen. We report here results of a retrospective analysis of prognostic factors for stage I testicular seminoma. Methods: Between January 1980 and December 2004, surveillance was performed for 61 patients. Tumor characteristics (age at diagnosis, size, elevation of beta hCG level, invasion of the rete testis, vascular invasion, and lymphatic invasion) were examined as factors possibly predictive of relapse. Cause-specific survival rate was calculated using the Kaplan-Meier method. Results: With a median follow-up of 10.5 years (range, 2.35–20.8 years), 7 relapses were observed, with an actuarial 5- year relapse-free rate (RFR) of 89.2%. On univariate analysis, only tumor size (RFR: <8cm, 96%; =8cm, 76%; p=0.029) was predictive of relapse. Age at diagnosis (RFR: <36, 89%; =36, 91%), elevation of beta hCG level (RFR: 93% [normal] v 91% [elevated]), invasion of the rete testis (RFR:92% [absent] v 90% [present]), vascular invasion (RFR:89% [absent] v 86% [present]), and lymphatic invasion (RFR: 89% [absent] v 78% [present]) were not predictive of relapse. The overall relapse rate was 11.5%. Overall 5-year survival rate was 97%. Conclusions: Size of primary tumor was found to be predictive of relapse in patients with stage I seminoma managed with surveillance, on analysis at a single institution in Japan. No significant financial relationships to disclose.

Two cycles of carboplatin as adjuvant therapy in stage I seminoma: 8-year experience by the Hellenic Co-operative Oncology Group (HECOG).

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 4558-4558
Author(s):  
Konstantinos Koutsoukos ◽  
Michael Liontos ◽  
Maria Lykka ◽  
Georgios Rigakos ◽  
Anna Andreadou ◽  
...  
Keyword(s):  
Relapse Rate ◽  
Medical Information ◽  
Salvage Chemotherapy ◽  
Rete Testis ◽  
Stage I ◽  
Rank Test ◽  
Tumor Diameter ◽  
Testicular Seminoma ◽  
Stage I Seminoma

4558 Background: Adjuvant chemotherapy is used in stage I testicular seminoma. We have reported a risk-adapted strategy of 2 cycles of cisplatin/etoposide (EP) in 64 patients with age < 34 and/or tumor diameter > 4cm) (Bamias et al, Urology 2007), resulting in no relapses over a median follow up of 5 years. Following the establishment of adjuvant carboplatin as a standard, we adopted this treatment for all patients with stage I seminoma. We report our 8-year experience and compare these results with our previous EP strategy. Methods: Patients with stage I seminoma, treated with 2 cycles of carboplatin AUC 6 and a minimum follow up of 1 year after chemotherapy were selected. All patients consented for the use of their medical information and the analysis was approved by the centers involved. Survival functions were presented using Kaplan-Meier curves. The log-rank test was used to test for survival differences across different categories. Results: 137 patients (Median age: 34; Age<34: 49%, tumor diameter>4cm: 42%; rete testis invasion: 24%), treated between 11/2003-12/2011 were selected. During a median follow up of 4 years, there were 5 relapses (5-y relapse rate [RR]: 97% [SE: 2%]): retroperitoneal lymph nodes (n=4) and isolated brain (n=1). All patients with relapse had tumor diameter > 4cm and/or age < 34. No relapse was associated with rete testis invasion. Patients with at least 1 of the above risk factors (n=94) had a significantly higher relapse rate compared with a similar population (n=64) treated with 2 cycles of adjuvant EP: 5-y RR was 95% (SE: 2%) vs.100% (SE 0%), (p=0.033). All relapsed patients were treated with BEP chemotherapy and are currently alive with no evidence of relapse. Neutropenia and nausea/vomiting were less frequent with carboplatin than with EP (11% vs. 36% and 15% vs. 65%). Conclusions: Our analysis confirms the association of age and tumor diameter with relapse in stage I seminoma treated with adjuvant carboplatin. Although adjuvant carboplatin in patients with age<34 and/or tumor diameter> 4 cm is associated with higher RR than EP, the prognosis of these patients is excellent with salvage chemotherapy and, therefore, the use of less toxic treatment is justified.

Stage I Seminoma of the Testis: Long Term Results and Toxicity with Adjuvant Radiotherapy

1994 ◽  
Vol 80 (2) ◽  
pp. 141-145 ◽  
Author(s):  
Maurizio Amichetti ◽  
Giovanni Fellin ◽  
Andrea Bolner ◽  
Lucia Busana ◽  
Giuseppe Pani ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Stage I ◽  
Long Term Results ◽  
Adjuvant Radiation ◽  
Actuarial Survival ◽  
Curative Intent ◽  
Testicular Seminoma ◽  
Stage I Seminoma ◽  
Cure Rates

Aims and background Pure testicular seminoma has historically been treated with post-orchidectomy radiation therapy with excellent results. Recently, several aspects of the treatment of stage I seminoma have been questioned. We assessed long-term results and toxicity of patients with pure testicular seminoma treated at the Department of Radiation Oncology of S. Chiara Hospital, Trento. Methods From 1953 to 1987, 102 patients with stage I pure testicular seminoma were given megavoltage irradiation with curative intent. All patients had a minimum follow-up of 3 years (maximum 37 years, median 13 years). They received a mean para-aortic/pelvic dose of 33.07 Gy (range 23.70-45.20 Gy) with different doses and fields reflecting the change in techniques over a long period of time. Results The cause-specific actuarial survival at 30 years was 99% and crude survival 67%. One patient had an out-field relapse (inguinal) after a few months and was cured with radiotherapy and chemotherapy. Another patient relapsed with widespared metastases and died after 1 year of progressive disease. Early toxycity was mild and the treatment was well tolerated. Late side effects were reported in 8/102 patients. Conclusion In our series adjuvant radiation therapy resulted in cure rates corresponding to those reported in the literature. The 30-year actuarial survival of 99% was extremely good and the toxicity of the treatment was mild. Post-orchidectomy radiation to the para-aortic and ipsilateral pelvic nodes is a safe and effective method of preventing recurrences and is currently to be considered the treatment of choice in stage I testicular seminoma.

Stage I Seminoma of the Testis. Adjuvant Radiotherapy or Surveillance?

1991 ◽  
Vol 68 (2) ◽  
pp. 190-194 ◽  
Author(s):  
E. P. ALLHOFF ◽  
SUSANNE LIEDKE ◽  
W. RIESE ◽  
C. STIEF ◽  
B. SCHNEIDER
Keyword(s):  
Adjuvant Radiotherapy ◽  
Stage I ◽  
Stage I Seminoma
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