Long-term Outcome of Stage I Seminoma

Yang, Gary; Li, Baoqing; Wagner, Timothy D.; Donohue, Kathleen; Flaherty, L.; Kuettel, Michael

doi:10.1097/01.coc.0000255613.72254.31

Cited by 2 publications

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“…Due to the overwhelming success of the treatment and the subsequent long-term survival, there has been growing interest in decreasing treatment-related morbidity in seminoma patients [3]. Long-term complications of radiotherapy include infertility and induction of secondary malignancy [1].…”

Section: Discussionmentioning

confidence: 99%

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Stage I seminoma: treatment outcome at King Hussein Cancer Center in Jordan

et al. 2012

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BackgroundThe aim of this report is to address treatment outcomes of patients with early-stage seminoma in a single institution with special reference to patients with history of surgical violation of the scrotum.MethodsSeventy four patients with pure seminoma were treated at King Hussein Cancer Center (Amman, Jordan) between 2003 and 2010. All patients underwent orchiectomy. All but 3 patients received adjuvant radiotherapy. Patients who underwent surgical violation of the scrotum prior to referral were managed by further excision or irradiation of the scrotal scar. The follow-up ranged from 1 to 200 months (mean, 33 months).ResultsAt the time of follow-up; all but one patient remain alive. The 3-year relapse-free survival for the entire cohort was 95.9%. Three patients developed relapse, all of whom received adjuvant irradiation following inguinal orchiectomy and initially harbored tumors larger than 4 cm upon pathological examination. Median time to relapse was 14 months (range, 8–25 months). None were associated with elevated tumor markers prior to detection of relapse. All but one patient were successfully salvaged by chemotherapy.ConclusionsOur results confirm the excellent prognosis of patients with early-stage seminoma treated by orchiectomy and adjuvant radiotherapy in a developing country. Although all patients who developed relapse demonstrated adverse pathological findings upon initial assessment, no consistent predictor of relapse was found. Scrotal scar re-excision or irradiation in patients with prior history of surgical violation of the scrotum are effective measures in preventing local failure.

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Section: Discussionmentioning

confidence: 99%

“…More than half of patients with testicular cancer are found to harbor a seminoma [2]. Over the past years, there has been a continuously increasing incidence of testicular seminoma in the Western world and Japan [3,4]. In the United States, 8480 new cases and 350 deaths were expected in 2010 [5].…”

Section: Introductionmentioning

confidence: 99%

Stage I seminoma: treatment outcome at King Hussein Cancer Center in Jordan

et al. 2012

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Late recurrence and salvage therapy of CNS germinomas

et al. 2008

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Central nervous system (CNS) germinoma is a curable tumor and its recurrence rate after initial therapy may be approximately 10% or higher. This study elucidates the time-course of recurrence and results of salvage therapy. Twenty-five patients with recurrent germinoma treated at Hokkaido University Hospital were retrospectively reviewed. The median age at initial treatment was 12 years (range: 8-37). All patients had been tumor-free for at least 6 months after the initial treatment. The median follow-up period was 134 months (range: 44-338). The median age at first recurrence was 18 years and the median time to the first recurrence was 50 months. Among the patients, 9 (36%) had the first recurrence at 60 months or later. The latest recurrence in a patient occurred 230 months after the initial treatment. The results of salvage therapy were estimated in all 25 patients. Seventeen patients (68%) were salvaged and were tumor-free at the final observation. The remaining 8 patients died of disease. At first recurrence, 11 patients were treated using radiation therapy with or without surgery and 7 out of the 11 patients died due to the recurrent tumor. On the other hand, 13 patients who received salvage chemotherapy and radiotherapy were tumor-free at the last follow-up. In conclusion, late recurrence is not a rare event in patients with CNS germinoma. To identify a true cure rate of this disease, a 10-year or longer observation period may be required. As a salvage therapy, platinum-based chemotherapy followed by wide-field low-dose radiation therapy appears to be effective.

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Long-term Outcome of Stage I Seminoma

Cited by 2 publications

References 21 publications

Stage I seminoma: treatment outcome at King Hussein Cancer Center in Jordan

Stage I seminoma: treatment outcome at King Hussein Cancer Center in Jordan

Late recurrence and salvage therapy of CNS germinomas

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