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- W356676474 abstract "4518 Background: Patients with stage I seminoma can be managed with surveillance, prophylactic irradiation or adjuvant chemotherapy. In a previous GG trial (Ann Oncol 2003;14:867) we demonstrated that adjuvant carboplatin may be restricted to patients with risk criteria (RC). The present study was designed to confirm the efficacy of this risk-adapted policy using the new International criteria (JCO 2002;20:4448). Methods: From January 1999 through December 2003, 300 patients (median age 32 years, range 19–66) with stage I seminoma (median tumor size 4.5 cm, range 3–14) were included. 96 (32%) of them had no RC and were managed with surveillance, whereas 125 (42%) had tumors >4 cm, 31 (10%) had rete testis involvement, and 48 (16%) had both RC. The latter 3 groups received single agent adjuvant carboplatin (AUC 7 x 2 cycles with a 21-day interval). Results: Chemotherapy was generally well tolerated, with uncomplicated grade 3–4 myelotoxicity in 7% of patients and grade 1 asthenia in 19%. Median follow-up time is 20 months (range, 1–60). Relapses were observed in 4 (4.2%) patients on surveillance and in 5 (2.4%) treated with adjuvant carboplatin (0.8% of tumors >4 cm, 3.2% of tumors invading rete testis, and 6.3% of tumors with both RC). All relapses were located at retroperitoneum (median size was 18 mm, range 11–35, and median time to relapse was 8 months, range 4–19). All these patients were rendered disease-free with chemotherapy (etoposide + cisplatin). Overall 3-year survival is 100%. Actuarial 3-year event-free survival is 96.4% for patients treated with adjuvant chemotherapy and 94.5% for patients on surveillance. Conclusions: Single-agent carboplatin is effective in reducing the relapse rate in patients with stage I seminoma and RC according to the new International score. A risk-adapted treatment policy is feasible in a national-wide multicenter setting. No significant financial relationships to disclose." @default.
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- W356676474 date "2004-07-15" @default.
- W356676474 modified "2023-09-26" @default.
- W356676474 title "Risk-adapted management of stage I seminoma: The second Spanish Germ Cell Cancer Group (GG) study" @default.
- W356676474 doi "https://doi.org/10.1200/jco.2004.22.90140.4518" @default.
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