Outcomes of surveillance versus adjuvant treatment for patients with stage-I seminoma: a single-center experience.
Adjuvant therapy
Disease free survival
Lymphovascular invasion
Overall survival
Seminoma
Surveillance
Journal
World journal of urology
ISSN: 1433-8726
Titre abrégé: World J Urol
Pays: Germany
ID NLM: 8307716
Informations de publication
Date de publication:
Aug 2023
Aug 2023
Historique:
received:
07
03
2023
accepted:
04
06
2023
medline:
11
8
2023
pubmed:
23
6
2023
entrez:
23
6
2023
Statut:
ppublish
Résumé
Testicular germ cell tumors (seminoma/non-seminoma) are the most common carcinomas in young males, comprising approximately 1% of all carcinomas. In stage-I disease, orchiectomy can cure approximately 85% of patients. Post-surgical options are adjuvant therapy and active surveillance. Our study examined the effects of management options on stage-I seminoma patients followed in our center. We evaluated the patients with stage-I testicular seminoma who underwent radical orchiectomy and followed up in the oncology center between 2001 and 2022. The outcomes of management options, survivals were retrospectively analyzed. The prognostic significance of risk factors for relapse on survival was evaluated. Of the 140 patients with stage-I seminoma, 49 (35%) were treated with adjuvant therapy, and 91 (65%) underwent surveillance. The median follow-up duration was 37 months. During the follow-up period, nine patients in the active surveillance group and four in the adjuvant therapy group had a recurrence. There was no statistically significant difference between the two groups (p = 0.67). In the surveillance group, the univariate and multivariate analyzes identified the presence of lymphovascular invasion (p = 0.005, HR: 0.13) as significant prognostic factor for disease-free survival (DFS). In the surveillance cohort, the 5-year DFS rate was 60% for patients with lymphovascular invasion and 93% for those without. There was statistical significance between the two groups (p = 0.003). Our study shows that adjuvant therapy does not significantly improve DFS compared to surveillance in patients. In addition, it has been shown that lymphovascular invasion is an important prognostic indicator for DFS in determining the treatment strategy.
Identifiants
pubmed: 37351618
doi: 10.1007/s00345-023-04482-0
pii: 10.1007/s00345-023-04482-0
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2201-2207Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Références
Siegel RL, Miller KD, Wagle NS, Jemal A (2023) Cancer statistics, 2023. CA Cancer J Clin 73:17
doi: 10.3322/caac.21763
pubmed: 36633525
Horwich A, Shipley J, Huddart R (2006) Testicular germ-cell cancer. Lancet 367:754–765
doi: 10.1016/S0140-6736(06)68305-0
pubmed: 16517276
Chia VM, Quraishi SM, Devesa SS, Purdue MP, Cook MB, McGlynn KA (2010) International trends in the incidence of testicular cancer, 1973–2002. Cancer Epidemiol Biomark Prev 19:1151–1159
doi: 10.1158/1055-9965.EPI-10-0031
Mead GM, Fossa SD, Oliver RT et al (2011) Randomized trials in 2466 patients with stage I seminoma: patterns of relapse and follow-up. JNatl Cancer Inst 103:241–249
doi: 10.1093/jnci/djq525
Glaser SM, Vargo JA, Balasubramani GK, Beriwal S (2016) Surveillance and radiation therapy for stage I seminoma-have we learned from the evidence? Int J Radiat Oncol Biol Phys 94:75–84
doi: 10.1016/j.ijrobp.2015.09.028
pubmed: 26700704
Travis LB, Curtis RE, Storm H, Hall P, Holowaty E, Van Leeuwen FE, Kohler BA, Pukkala E, Lynch CF, Andersson M et al (1997) Risk of second malignant neoplasms among long-term survivors of testicular cancer. J Natl Cancer Inst 89:1429–1439
doi: 10.1093/jnci/89.19.1429
pubmed: 9326912
Krege S, Beyer J, Souchon R, Albers P, Albrecht W, Algaba F, Bamberg M, Bodrogi I, Bokemeyer C, Cavallin-Ståhl E et al (2008) European consensus conference on diagnosis and treatment of germ cell cancer: A report of the second meeting of the European Germ Cell Cancer Consensus group (EGCCCG): Part I. Eur Urol 53:478–496
doi: 10.1016/j.eururo.2007.12.024
pubmed: 18191324
Motzer RJ, Agarwal N, Beard C, Bolger GB, Boston B, Carducci MA, Choueiri TK, Figlin RA, Fishman M, Hancock SL et al (2009) NCCN clinical practice guidelines in oncology: testicular cancer. J Natl Compr Cancer Netw JNCCN 7:672–693
doi: 10.6004/jnccn.2009.0047
pubmed: 19555582
National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology, Testicular Cancer – Pure Seminoma. https://www.nccn.org/professionals/physician_gls/pdf/testicular.pdf . Accessed 31 May 2023
Cohn-Cedermark G, Stahl O, Tandstad T (2015) Surveillance vs. adjuvant therapy of clinical stage I testicular tumors—a review and the SWENOTECA experience. Andrology 3:102–110
doi: 10.1111/andr.280
pubmed: 25270123
Oliver RT, Mason MD, Mead GM, von der Maase H, Rustin GJ, Joffe JK, de Wit R, Aass N, Graham JD, Coleman R, Kirk SJ, Stenning SP (2005) Radiotherapy versus single-dose carboplatin in adjuvant treatment of stage I seminoma: a randomised trial. Lancet 366:293–300
doi: 10.1016/S0140-6736(05)66984-X
pubmed: 16039331
Aparicio J, Germà JR, García del Muro X, Maroto P, Arranz JA, Sáenz A, Barnadas A, Dorca J, Gumà J, Olmos D, Bastús R, Carles J, Almenar D, Sánchez M, Paz-Ares L, SatrústeguiJJ MB, Balil A, López-Brea M, Sánchez A (2005) Riskadapted management for patients with clinical stage I seminoma: the Second Spanish Germ Cell Cancer Cooperative Group study. J Clin Oncol 23:8717–8723
doi: 10.1200/JCO.2005.01.9810
pubmed: 16260698
Warde P, Specht L, Horwich A, Oliver T, Panzarella T, Gospodarowicz M, von der Maase H (2002) Prognostic factors for relapse in stage I seminoma managed by surveillance: a pooled analysis. J Clin Oncol 20:4448–4452
doi: 10.1200/JCO.2002.01.038
pubmed: 12431967
Brierley JD, Gospodarowicz MK, Wittekind C et al (2017) (eds) TNM classification of malignant tumours. 8th edn. Wiley Blackwell, Oxford, UK
Oldenburg J, Fossa SD, Nuver J, Heidenreich A, Schmoll HJ et al (2015) Testicular seminoma and non-seminoma: ESMO in clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 26:833–838
doi: 10.1093/annonc/mdu514
pubmed: 25378299
Boujelbene N, Cosinschi A, Boujelbene N, Khanfir K, Bhagwati S, Herrmann E, Mirimanoff RO, Ozsahin M, Zouhair A (2011) Pure seminoma: a review and update. Radiat Oncol 6:90
doi: 10.1186/1748-717X-6-90
pubmed: 21819630
pmcid: 3163197
Warde P, Gospodarowicz MK, Panzarella T, Catton CN, Sturgeon JF, Moore M, Goodman P, Jewett MA (1995) Stage I testicular seminoma: results of adjuvant irradiation and surveillance. J Clin Oncol 13:2255–2262
doi: 10.1200/JCO.1995.13.9.2255
pubmed: 7666083
Haugnes HS, Bosl GJ, Boer H et al (2012) Long-term and late effects of germ cell testicular cancer treatment and implications for follow-up. JCO 30:3752–3763
doi: 10.1200/JCO.2012.43.4431
Kier MG, Hansen MK, Lauritsen J et al (2016) Second malignant neoplasms and cause of death in patients with germ cell cancer: a Danish nationwide cohort study. JAMA Oncol 2:1624–1627
doi: 10.1001/jamaoncol.2016.3651
pubmed: 27711914
Dieckmann KP, Dralle-Filiz I, Heinzelbecker J, Matthies C, Bedke J, Ellinger J, Sommer J, Haben B, Souchon R, Anheuser P et al (2016) Seminoma clinical stage 1—patterns of care in Germany. Urol Int 96(4):390–398
doi: 10.1159/000443214
pubmed: 27092560
Zengerling F, Kunath F, Jensen K, Ruf C, Schmidt S, Spek A (2018) Prognostic factors for tumor recurrence in patients with clinical stage I seminoma undergoing surveillance-a systematic review. Urol Oncol 36(10):448–458
doi: 10.1016/j.urolonc.2017.06.047
pubmed: 28712790
Nayan M, Jewett MA, Hosni A, Anson-Cartwright L, Bedard PL, Moore M, Hansen AR, Chung P, Warde P, Sweet J et al (2017) Conditional risk of relapse in surveillance for clinical stage I testicular cancer. Eur Urol 71(1):120–127
doi: 10.1016/j.eururo.2016.07.013
pubmed: 27527805
Aparicio J, Maroto P, García Del Muro X, Sánchez-Muñoz A, Gumà J, Margelí M, Sáenz A, Sagastibelza N, Castellano D, Arranz JA et al (2014) Prognostic factors for relapse in stage I seminoma: a new nomogram derived from three consecutive, risk-adapted studies from the Spanish Germ Cell Cancer Group (SGCCG). Ann Oncol 25(11):2173–2178
doi: 10.1093/annonc/mdu437
pubmed: 25210015
Tandstad T, Smaaland R, Solberg A, Bremnes RM, Langberg CW, Laurell A, Stierner UK, Ståhl O, Cavallin-Ståhl EK, Klepp OH et al (2011) Management of seminomatous testicular cancer: a binational prospective population-based study from the Swedish Norwegian testicular cancer study group. J Clin Oncol 29(6):719–725
doi: 10.1200/JCO.2010.30.1044
pubmed: 21205748
Ondrusova M, Ondrus D, Miskovska V, Kajo K, Szoldova K, Usakova V, Stastna V (2015) Management of clinical stage I testicular seminoma: active surveillance versus adjuvant chemotherapy. Int Urol Nephrol 47(7):1143–1147
doi: 10.1007/s11255-015-1002-4
pubmed: 25982582
von der Maase H, Specht L, Jacobsen GK et al (1993) Surveillance following orchidectomy for stage I seminoma of the testis. Eur J Cancer 14:1931–1934
doi: 10.1016/0959-8049(93)90446-M
Horwich A, Alsanjari N, A’Hern R et al (1992) Surveillance following orchidectomy for stage I testicular seminoma. Br J Cancer 65:775–778
doi: 10.1038/bjc.1992.164
pubmed: 1586607
pmcid: 1977398
Chung P, Daugaard G, Tyldesley S et al (2015) Evaluation of a prognostic model for risk of relapse in stage I seminoma surveillance. Cancer Med 4:155–160
doi: 10.1002/cam4.324
pubmed: 25236854
Dieckmann KP, Dralle-Filiz I, Matthies C, Heinzelbecker J, Bedke J, Ellinger J, Anheuser P, Souchon R, Pichlmeier U (2016) Testicular seminoma clinical stage 1: treatment outcome on a routine care level. J Cancer Res Clin Oncol 142(7):1599–1607
doi: 10.1007/s00432-016-2162-z
pubmed: 27116691
pmcid: 4899489
Bilici A, Ozturk T, Turkmen E, Odabas H et al (2015) Treatment preferences in stage IA and IB testicular seminoma: multicenter study of Anatolian Society of Medical Oncology. World J Urol 33(10):1613–1622
doi: 10.1007/s00345-015-1492-9
pubmed: 25605506