A Risk-Adapted Approach to Patients with Stage I Seminoma according to the Status of Rete Testis: The Fourth Spanish Germ Cell Cancer Group Study

Fecha de publicación:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Sanchez-Munoz, A
  • Guma, J
  • Domenech, M
  • Meana, JA
  • Garcia-Sanchez, J
  • Bastus, R
  • Girones, R
  • Gonzalez-Billalabeitia, E
  • Sagastibelza, N
  • Ochenduszko, S
  • Sanchez, A
  • Terrasa, J
  • Germa-Lluch, JR
  • García Del Muro X
  • on behalf of the Spanish Germ Cell Cancer Group

Grupos

Abstract

Objective: The aim of this study was to assess a risk-adapted strategy for stage I seminoma guided by the presence of rete testis invasion. Methods: Between January 2013 and December 2015, a total of 135 consecutive patients with stage I seminoma from 18 Spanish tertiary hospitals were included in a prospective multicenter study. Median patient age was 38 years (range 22-60). Preoperative beta-human chorionic gonadotropin was elevated in 9.6% of patients. Rete testis invasion was present in 47.4% of patients. After orchiectomy, subjects with rete testis invasion were treated with 2 courses of adjuvant carboplatin (area under the curve of 7, with 21day interval). Those without this risk factor were managed by surveillance. Disease-free survival (DFS) and overall survival (OS) were estimated with the Kaplan-Meier method. Results: After a median follow-up time of 33 months, only 6 relapses were recorded (5 on surveillance, 1 after carboplatin). These cases were rescued with BEP or EP chemotherapy, and all 135 patients are currently disease free without sequelae. Threeyear DFS was 92.0 and 98.2% for patients on surveillance and after carboplatin, respectively. Three-year OS was 100%. Conclusion: A risk-adapted approach based on rete testis invasion as a single risk factor is feasible and yielded an excellent outcome with a 3-year DFS of 94.9%. (C) 2018 S. Karger AG, Basel

Datos de la publicación

ISSN/ISSNe:
0030-2414, 1423-0232

ONCOLOGY  KARGER

Tipo:
Article
Páginas:
8-12
PubMed:
29587278
Factor de Impacto:
0,846 SCImago
Cuartil:
Q2 SCImago

Citas Recibidas en Web of Science: 11

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Keywords

  • Adjuvant chemotherapy; Carboplatin; Rete testis invasion; Seminoma; Surveillance

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