scholarly journals Controversies in the management of clinical stage I testicular seminoma

2016 ◽  
Vol 69 (1) ◽  
Keyword(s):  
Clinical Stage ◽  
Stage I ◽  
Testicular Seminoma

Late gastrointestinal (GI) complications in patients with stage I-II testicular seminoma treated with radiotherapy (RT).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 4595-4595 ◽  
Author(s):  
Christopher Leigh Hallemeier ◽  
Brian Davis ◽  
Thomas Michael Pisansky ◽  
Richard Choo
Keyword(s):  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Clinical Stage ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Stage I ◽  
Gi Tract ◽  
Curative Intent ◽  
Testicular Seminoma ◽  
Late Morbidity

4595 Background: For stage I-II testicular seminoma, RT is highly effective at eradicating disease in the abdominopelvic lymph nodes, but results in unnecessary exposure to normal tissues including the GI tract. The purpose of this study was to define the incidence and risk factors for late GI complications in this patient population. Methods: A retrospective review was performed of 251 patients with stage I-II testicular seminoma treated with curative intent RT at our institution from 1974-2009. All patients underwent orchiectomy and postoperative external beam RT to the involved and/or at-risk nodal basins. Potential late GI complications that were assessed included endoscopically-confirmed gastric or duodenal ulceration, small bowel obstruction (SBO), and biopsy-confirmed malignancy of the GI tract. Risks were estimated using the Kaplan-Meier (KM) technique and univariate/multivariate analyses were performed using the Cox proportional hazards model. Results: Median age at diagnosis was 36 years (range 18 – 80). Clinical stage was I (n=199) or II (n=52). Median abdominopelvic RT dose was 26 Gy (interquartile range 25 – 30). Median follow-up was 15 years (range 0.1 – 38). KM estimates for any GI complication (ulcer, SBO, or GI malignancy) at 10, 20, and 30 years were 7, 10 and 24%, respectively. Four patients died as result of a GI complication. KM estimates for ulcer at 10, 20, and 30 years were 4, 7, and 9%, respectively. Age at RT (Hazard Ratio [HR] 1.05, 95% Confidence Interval [CI] 1.00 – 1.10, p=0.03) and RT total dose (per Gy, HR 1.20, 95% CI 1.09 – 1.31, p<0.01) were associated with risk of ulcer. KM estimates for SBO at 10, 20, and 30 years were 2%, 2%, and 3%, respectively. History of inflammatory bowel disease was associated with risk of SBO (HR 43, 95% CI 7-325, p<0.01). KM estimates for GI malignancy at 10, 20, and 30 years were 0.5, 3 and 16%, respectively. Age at RT was associated with risk of GI malignancy (HR 1.07, 95% CI 1.02-1.14, p=0.01). Conclusions: In patients with stage I-II testicular seminoma treated with RT, late GI complications were a relatively uncommon, but clinically significant source of late morbidity. Use of low dose, limited field, and/or proton RT may reduce these risks.

Adjuvant carboplatin for clinical stage I testicular seminoma in New Zealand centers: Retrospective analysis of efficacy and long-term adverse effects.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e16041-e16041 ◽  
Author(s):  
Elias Aris Chandran ◽  
Aaron Farai Chindewere ◽  
Richard T. North ◽  
Michael B. Jameson
Keyword(s):  
Adverse Effects ◽  
Retrospective Analysis ◽  
Tumour Size ◽  
Clinical Stage ◽  
The Body ◽  
Stage I ◽  
Malignant Neoplasms ◽  
Testicular Seminoma ◽  
Long Term Adverse Effects

e16041 Background: Adjuvant carboplatin reduces relapse risk in clinical stage I (CS1) testicular seminoma, though there is a paucity of long-term safety data. While some studies report that two cycles is more effective than one, there is no randomised trial evidence or consensus on the optimal number of cycles. European guidelines recommend a risk-based approach to consider adjuvant carboplatin in those with either rete testis involvement (RTI) or tumour size > 4cm, and surveillance for other patients. We report long-term outcomes of 2 cycles of adjuvant carboplatin dosed at area under the curve (AUC) of 7 as standard management of CS1 seminoma since 2000. Methods: We performed a retrospective analysis on treatment and outcomes of patients with CS1 seminoma who received adjuvant carboplatin from 2000 to 2016 at the Waikato, Lakes and Bay of Plenty District Health Boards. We also collected information on mortality, causes of death and subsequent malignant neoplasms (SMN). Results: Of 160 patients, median age 39 (range 20-73) years, 154 received 2 cycles of carboplatin: 148 dosed at AUC7 and six at AUC6; another six patients had one cycle of carboplatin AUC7, curtailed due to toxicity in 3 patients. Two relapses occurred: one at 10 months (in hindsight stage 2a at diagnosis) and one at 22 months (died of pulmonary embolism 2 months after achieving complete response with BEP chemotherapy). Neither RTI (present in 21.3%) nor tumour size > 4cm (in 43.1%) were predictive of relapse. No patients died of seminoma. At median follow up of 109 (range 17-209) months, relapse-free survival was 98.7%, overall survival was 97.5% and disease-specific survival was 100%. A SMN occurred in 11 patients (6.9%) at median 96 months and caused 4 deaths (melanoma, myeloma, small cell lung cancer and glioblastoma); 4 patients (2.6%) had a contralateral testicular germ cell tumour (at median 69 months). One patient had persistent grade 1 thrombocytopenia at 46 months. Conclusions: This data adds to the body of evidence that two cycles of carboplatin AUC7 is safe, effective adjuvant treatment for CS1 seminoma. It did not have significant long-term adverse effects in our population.

Management of clinical stage I testicular seminoma: active surveillance versus adjuvant chemotherapy

2015 ◽  
Vol 47 (7) ◽  
pp. 1143-1147 ◽  
Author(s):  
M. Ondrusova ◽  
D. Ondrus ◽  
V. Miskovska ◽  
K. Kajo ◽  
K. Szoldova ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Active Surveillance ◽  
Clinical Stage ◽  
Stage I ◽  
Testicular Seminoma

Incidence of second malignancies after external beam radiotherapy for clinical stage I testicular seminoma

2011 ◽  
Vol 109 (5) ◽  
pp. 706-712 ◽  
Author(s):  
Dan Lewinshtein ◽  
Roman Gulati ◽  
Peter S. Nelson ◽  
Christopher R. Porter
Keyword(s):  
External Beam Radiotherapy ◽  
Clinical Stage ◽  
Stage I ◽  
External Beam ◽  
Second Malignancies ◽  
Testicular Seminoma

New Guidelines for Clinical Stage I Testicular Seminoma?

Oncology ◽  
2005 ◽  
Vol 69 (6) ◽  
pp. 455-462 ◽  
Author(s):  
F. Christoph ◽  
S. Weikert ◽  
K. Miller ◽  
M. Schrader
Keyword(s):  
Clinical Stage ◽  
Stage I ◽  
Testicular Seminoma ◽  
New Guidelines

Postsurgical Policy in Stage I Testicular Seminoma: Cost and Benefit of Prophylactic Irradiation in a Long-term Experience

1997 ◽  
Vol 83 (6) ◽  
pp. 918-921 ◽  
Author(s):  
Silvia Tana ◽  
Annamaria Cerrotta ◽  
Gianstefano Gardani ◽  
Mauro Palazzi ◽  
Giorgio Pizzocaro
Keyword(s):  
Clinical Stage ◽  
Disease Free Survival ◽  
Cost Benefit ◽  
Stage I ◽  
Regional Lymph Nodes ◽  
Testicular Seminoma ◽  
Cost Benefit Ratio ◽  
Wait And See ◽  
Prophylactic Irradiation ◽  
The Cost

The definitive cure rate for clinical stage I testicular seminoma is very close to 100%, and prophylactic irradiation of the regional lymph nodes is associated with a low morbidity. Nevertheless, in recent years a “wait-and-see” policy has been proposed by some researchers. We analysed the cost/benefit ratio of radiotherapy (RT) by review of the case histories of 299 patients treated at the Department of Radiotherapy of the Istituto Nazionale per lo Studio e la Cura dei Tumori in Milan from January 1968 to December 1989. The 5-year overall survival was 99% (97.5% at 10 years), while the 10-year disease-free survival was 96%. The recurrence rate was 2.3%, but no patient relapsed in the irradiated areas. Acute toxicity was very moderate with only 4 (1.3%) serious radiation sequelae occurring 6 to 27 years after treatment. However, 9 second malignancies (3%) were observed. Lastly, we have calculated the costs for our National Health Service comparing surveillance policy and prophylactic irradiation.

427: Long Term Results of Laparoscopic Retroperitoneal Lymph Node Dissection in Clinical Stage I NSGCT

2005 ◽  
Vol 173 (4S) ◽  
pp. 116-117
Author(s):  
Hannes Steiner ◽  
Reinhard Peschel ◽  
Tilko Müller ◽  
Christian Gozzi ◽  
Georg C. Bartsch ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Dissection ◽  
Clinical Stage ◽  
Stage I ◽  
Long Term Results ◽  
Retroperitoneal Lymph Node Dissection ◽  
Node Dissection ◽  
Retroperitoneal Lymph Node

Serum Lactate Dehydrogenase Isoenzyme 1 and Relapse in Patients with Nonseminomatous Testicular Germ Cell Tumors Clinical Stage I

2001 ◽  
Vol 40 (4) ◽  
pp. 536-540 ◽  
Author(s):  
Finn Edler von Eyben ◽  
Ebbe Lindegaard Madsen ◽  
Ole Blaabjerg ◽  
Per Hyltoft Petersen ◽  
Hans von der Maase ◽  
...  
Keyword(s):  
Lactate Dehydrogenase ◽  
Germ Cell ◽  
Clinical Stage ◽  
Germ Cell Tumors ◽  
Serum Lactate ◽  
Stage I ◽  
Serum Lactate Dehydrogenase ◽  
Testicular Germ Cell Tumors ◽  
Testicular Germ Cell ◽  
Dehydrogenase Isoenzyme
Sign in / Sign up

Export Citation Format

Share Document