Cisplatin-based chemotherapy for advanced seminoma: report of 52 cases treated in two institutions

Giannis, Mountzios; Bamias, Aristotelis; Koutsoukou, Vassiliki; Anastasiou, Ioannis; Stravodimos, Konstantinos; Antoniou, Nikolaos; Georgios, Papadopoulos; Georgios, Pavlakis; Papassavas, Pantelis; Meletios-Athanasios, Dimopoulos

doi:10.1007/s00432-009-0596-2

Cited by 14 publications

(10 citation statements)

References 23 publications

(30 reference statements)

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“…After 69 months of follow-up, one patient in the IBEP group and two patients in the BEP group had relapsed. Taking into account the small study size, the authors conclude that the addition of ifosfamide to BEP in this patient population produces increased toxicity without evidence of superiority and is therefore not justified [17].…”

Section: Treatment Of Advanced Diseasementioning

confidence: 94%

“…Forty-seven patients (90.8%) were considered to have low-risk disease by the International Germ Cell Cancer Collaborative Group (IGCCCG) consensus criteria and received four cycles of BEP, whereas five patients (9.2%) had intermediate-risk disease and received four cycles of BEP with ifosfamide (IBEP). Hematologic toxicity was higher in the IBEP group, with two cases of neutropenic fever and one case of grade 3 thrombocytopenia [17]. After 69 months of follow-up, one patient in the IBEP group and two patients in the BEP group had relapsed.…”

Section: Treatment Of Advanced Diseasementioning

confidence: 95%

“…The standard of care for good/low-risk advanced seminomatous GCT (SGCT) is four cycles of etoposide and cisplatin (EP) or three cycles of BEP, whereas for intermediate-risk advanced SGCT it is four cycles of BEP. Giannis et al [17] conducted a retrospective analysis of 52 patients with advanced pure seminoma. Forty-seven patients (90.8%) were considered to have low-risk disease by the International Germ Cell Cancer Collaborative Group (IGCCCG) consensus criteria and received four cycles of BEP, whereas five patients (9.2%) had intermediate-risk disease and received four cycles of BEP with ifosfamide (IBEP).…”

Section: Treatment Of Advanced Diseasementioning

confidence: 99%

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Update on testicular germ cell tumors

Mannuel¹,

Hussain²

2010

Current Opinion in Oncology

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Section: Treatment Of Advanced Diseasementioning

confidence: 94%

Section: Treatment Of Advanced Diseasementioning

confidence: 95%

Section: Treatment Of Advanced Diseasementioning

confidence: 99%

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Update on testicular germ cell tumors

Mannuel¹,

Hussain²

2010

Current Opinion in Oncology

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“…These results were confirmed by Garcia-del-Muro et al [4], who assigned 72 patients with pure seminoma to 4 cycles of cisplatin/etoposide or 3 PEB cycles with an overall 5-year progression-free and overall survival rate of 90 and 95%, respectively, at a median follow-up of 71.5 months. Giannis et al [28] also concluded that patients with low-volume metastatic stage IIA and IIB seminoma can be treated by 4 cycles of PEB instead of radiotherapy with the risk of diverse toxicity effect. A different chemotherapy strategy was studied by Krege et al [29], investigating the use of single-agent carboplatin at a dose of AUC 7 in 108 patients with seminoma stages IIA (3 cycles) and IIB (4 cycles).…”

Section: Discussionmentioning

confidence: 99%

“…between 2002 and 2011) confirm that only patients with residual retroperitoneal masses >3 cm in diameter or PET-scan-positive patients should be considered for surgery (RPLND), while patients with masses <3 cm should undergo surveillance with close observation [18,28,32]. As most of the patients in our study were treated before that time, laparoscopic RPLND was performed in 2 patients (in 1999 and 2002) 6 weeks after chemotherapy with residual masses <3 cm (but >1.5 cm) according to institutional practice at that time.…”

Section: Discussionmentioning

confidence: 99%

Two Cycles of Cisplatin-Based Chemotherapy for Low-Volume Stage II Seminoma: Results of a Retrospective, Single-Center Case Series

et al. 2012

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Background: To report on the oncological outcome and toxicity of patients treated with 2 cycles of cisplatin-based chemotherapy for low-volume metastatic stage II seminoma. Methods: We retrospectively identified a case series of 15 patients with seminoma stage IIA (26.7%) and IIB (73.3%) who underwent chemotherapy consisting of 2 cycles of cisplatin, etoposide and bleomycin (PEB) (cisplatin 20 mg/m² on days 1–5, etoposide 100 mg/m² on days 1–5, bleomycin 30 mg on days 1, 8 and 15) according to patient preference (refusing a 3rd cycle of PEB) or institutional practice in the last decades. Complete staging before chemotherapy was available in all patients. Patient age, the side and diameter of the primary tumor, the size of the lymph nodes before and after chemotherapy, acute and late toxicity of chemotherapy, the incidence of second malignancies, the relapse-free rate and cancer-specific mortality were recorded. Results: Chemotherapy was well tolerated and no episode of febrile neutropenia occurred. Thrombocytopenia grade 4 was not seen in any patient, while leukopenia grade 4 was observed in 4 (26.6%) patients. The mean (range) lymph node size decreased significantly from 2.54 cm (1.1–4.0) before chemotherapy to 0.75 cm (0.4–2.2) after chemotherapy (p < 0.001). After a median (range) follow-up of 60 (13–185) months, no patient had relapsed, no patient had died as a result of seminoma and second malignancy was seen in only 1 (6.6%) patient. Conclusions: These excellent long-term results from a retrospective case series of 2 cycles of PEB in stage IIA/IIB seminoma patients represent a hint for further research with a view to reducing treatment burden. However, these incidental findings should be studied in prospective trials prior to drawing any conclusions.

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Therapy of clinical stage IIA and IIB seminoma: a systematic review

et al. 2021

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Purpose The optimal treatment for clinical stage (CS) IIA/IIB seminomas is still controversial. We evaluated current treatment options. Methods A systematic review was performed. Only randomized clinical trials and comparative studies published from January 2010 until February 2021 were included. Search items included: seminoma, CS IIA, CS IIB and therapy. Outcome parameters were relapse rate (RR), relapse-free (RFS), overall and cancer-specific survival (OS, CSS). Additionally, acute and long-term side effects including secondary malignancies (SMs) were analyzed. Results Seven comparative studies (one prospective and six retrospective) were identified with a total of 5049 patients (CS IIA: 2840, CS IIB: 2209). The applied treatment modalities were radiotherapy (RT) (n = 3049; CS IIA: 1888, CSIIB: 1006, unknown: 155) and chemotherapy (CT) or no RT (n = 2000; CS IIA: 797, CS IIB: 1074, unknown: 129). In CS IIA, RRs ranged from 0% to 4.8% for RT and 0% for CT. Concerning CS IIB RRs of 9.5%–21.1% for RT and of 0%–14.2% for CT have been reported. 5-year OS ranged from 90 to 100%. Only two studies reported on treatment-related toxicities. Conclusions RT and CT are the most commonly applied treatments in CS IIA/B seminoma. In CS IIA seminomas, RRs after RT and CT are similar. However, in CS IIB, CT seems to be more effective. Survival rates of CS IIA/B seminomas are excellent. Consequently, long-term toxicities and SMs are important survivorship issues. Alternative treatment approaches, e.g., retroperitoneal lymph node dissection (RPLND) or dose-reduced sequential CT/RT are currently under prospective investigation.

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Cisplatin-based chemotherapy for advanced seminoma: report of 52 cases treated in two institutions

Cited by 14 publications

References 23 publications

Update on testicular germ cell tumors

Update on testicular germ cell tumors

Two Cycles of Cisplatin-Based Chemotherapy for Low-Volume Stage II Seminoma: Results of a Retrospective, Single-Center Case Series

Therapy of clinical stage IIA and IIB seminoma: a systematic review

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