Adult urologyLong-term experience with carboplatin monotherapy for clinical stage I seminoma: a retrospective single-center study
Section snippets
Material and methods
Patients with histologic evidence of pure clinical stage I seminoma and clear surgical margins were eligible for single-agent carboplatin chemotherapy. Staging was performed according to the criteria recommended by the “Workshop for Staging and Treatment of Testicular Cancer” (Lugano 1979). In addition, computed tomography of the thorax, abdomen, and pelvis, as well as blood chemistry, including alpha-fetoprotein, beta-human chorionic gonadotropin (HCG), and lactate dehydrogenase (LDH)
Results
The pathologic tumor stage in the 108 patients was pT1 in 88, pT2 in 16, and pT3 in 4 patients. Small vessel invasion occurred in 13 patients (12%). In 13 patients (12%), the tumor was more than 6 cm in size, and 95 patients had tumors 6 cm or less in size. At the time of orchiectomy, 49 patients (45.3%) were 34 years old or younger. Of the 108 patients, 13 presented with preoperatively elevated beta-HCG levels; 10 patients had levels between 10 and 80 mU/mL and 3 patients had higher levels
Comment
Clinical Stage I seminoma is a highly curable disease with a very low death rate. With the above-mentioned treatment strategies, the disease-specific survival rate approaches 100%.8 Postorchiectomy radiotherapy to the para-aortic and ipsilateral pelvic lymph nodes has been the reference standard adjuvant treatment for clinical Stage I seminoma in the past decades.1, 8 The radiation field was recently restricted to the para-aortic lymph nodes, yielding equal results in terms of survival and
Conclusions
Overall, the results of our study confirm several published reports that in patients with clinical Stage I seminoma of the testis, two cycles of carboplatin monotherapy is an oncologically effective and well-tolerated treatment modality associated with very low morbidity.
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2010, Clinical OncologyCitation Excerpt :The results of the studies did not change significantly, and the conclusions were confirmed with longer follow-up. In total, 24 non-randomised studies were identified in 26 reports, two of which were identified in the 2009 update [22–47]. Overall survival estimates from these studies are summarised in Table 5.