Outcomes of surveillance versus adjuvant chemotherapy for patients with stage IA and IB nonseminomatous testicular germ cell tumors

Gümüş, Mahmut; Bılıcı, Ahmet; Odabaş, Hatice; Ustaalioğlu, Bala Basak Oven; Kandemir, Nurten; Demirci, Umut; Cihan, Şener; Bayoğlu, İbrahim Vedat; Ozturk, Turkan; Türkmen, Esma; Urakci, Zurat; Şeker, Mehmet; Gunaydin, Yusuf; Selçukbiricik, Fatih; Turan, Nedim; Sevinç, Alper

doi:10.1007/s00345-016-1964-6

Cited by 13 publications

(9 citation statements)

References 28 publications

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“…Patient autonomy should be respected and in order to help the patients, it is necessary to give patients information on different short and long-term risks with adjuvant treatment versus full chemotherapy, in case of relapse. Treating in the adjuvant situation decreases the risk of relapse significantly [29,49] and hence reduces the risk of side-effects caused by multiple courses of chemotherapy needed in case of metastatic disease.…”

Section: Annals Of Oncologymentioning

confidence: 99%

Sperm count in Swedish clinical stage I testicular cancer patients following adjuvant treatment

et al. 2019

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Background: Little is known regarding sperm production following adjuvant treatment in testicular cancer (TC) clinical stage I (CS I) patients.Patients and methods: A total of 182 TC patients aged 18-50 years were prospectively included during 2001-2006 at any given time within 5 years of orchiectomy. Semen samples were delivered postorchiectomy but before further treatment, 6, 12, 24, 36 and 60 months (T 0 -T 60 ) after completed therapy. Total sperm number (TSN) and sperm concentration (SC) were used as measurements of testicular function. Four groups according to treatment modality were identified; Radiotherapy; To a total dose of 25.2 Gy to the infradiaphragmal paraaortic and ipsilateral iliac lymph nodes (RT, N ¼ 70), one cycle of adjuvant BEP (bleomycin, etoposide, cisplatin, 5 day regimen) (BEP, N ¼ 62), one cycle of adjuvant carboplatin AUC 7 (Carbo, N ¼ 22), and patients managed by surveillance (SURV, N ¼ 28).Results: In the cross-sectional analysis, a significant but transient drop in mean TSN and mean SC (T 0 -T 60 ) was seen at T 6 after radiotherapy. Apart from a significant increase in mean SC at T 12 compared with baseline, no significant differences were observed in the other treatment groups. In 119 patients delivering 3 or more samples, values in TSN and SC were rather stable over time. Azoospermic patients (N ¼ 11) were observed in most treatment groups except for in the BEP group. During followup, one azoospermic patient belonging to the Carbo group became normospermic. Conclusions:No clinically significant long-term effect on TSN or SC associated with adjuvant treatment in TC CSI patients was found. However, as patients may have low sperm counts before orchiectomy as well as after adjuvant treatment, we offer sperm banking before orchiectomy as assisted reproductive measures may be necessary regardless of treatment given.

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Section: Annals Of Oncologymentioning

confidence: 99%

Sperm count in Swedish clinical stage I testicular cancer patients following adjuvant treatment

et al. 2019

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“…Similarly, with regard to postoperative adjuvant therapy, it has been reported that recurrence of nonseminomatous testicular germ cell tumors of stage IA and IB is significantly reduced by performing adjuvant chemotherapy [17]. However, in this case, there is no clear evidence of the effectiveness of adjuvant therapy when gross curative resection is performed.…”

Section: Discussionmentioning

confidence: 89%

Primary Duodenal Carcinoma with Embryonal Carcinoma Features in a Young Man

Yamamoto

Washimi

Murakawa

et al. 2021

Case Rep Gastroenterol

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We present the case of a 35-year-old man with intractable nausea, vomiting, and severe anemia. A computed tomography (CT) scan of the chest, abdomen, and pelvis showed a circumferential lesion thickening of up to 3.5 cm at the level of the third portion of the duodenum. No aortocaval, retroperitoneal lymphadenopathy, nor secondary lesion was observed. Esophagogastroduodenoscopy (EGD) revealed a circumferential mass within the third portion of the duodenum. Histopathology of biopsy materials from the duodenal mass showed it most likely to be a poorly differentiated adenocarcinoma. The patient underwent a subtotal stomach-preserving pancreaticoduodenectomy with regional lymph node dissection. Histologically, tumor cells with basophilic cytoplasm and pleomorphic nuclei showed a solid pattern, and expressed CD30 and SALL4 immunohistochemically, leading to a diagnosis of embryonal carcinoma-like tumor. No other primary tumor could be identified, and the location of the tumor, mainly on the mucosal surface, suggested a duodenal origin. The UICC TNM staging was T3N2M0, stage IIB. This is a rare case of primary duodenal carcinoma with features of embryonal carcinoma.

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“…Post-surgical treatment was based on histopathologic features and disease stage at surgery (2,27,28). Management options after surgery included surveillance, adjuvant chemotherapy, radiotherapy and RPLND (2,30). Considering the relatively low risk of relapse in testicular cancer, many guidelines recommend surveillance as the preferred initial treatment for all stage I SGCT and low-risk stage I NSGCT (31).…”

Section: Discussionmentioning

confidence: 99%

“…Eventual relapses may be cured by radiation or chemotherapy (2). Adjuvant treatments have declined in recent decades, as surveillance has been increasingly used to avoid unnecessary treatment and related long-term toxicities (2,30). Indeed, historically active surveillance became an option in the 1980's when it was demonstrated that cisplatin-based chemotherapy could cure almost all recurrences.…”

Section: Discussionmentioning

confidence: 99%

Testicular germ cells tumors in adolescents and young adults: Management and outcomes from a single-center experience

Spinelli

Cito

Morelli

et al. 2021

Arch Ital Urol Androl

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Objective: To investigate and compare the effectiveness of active surveillance versus post-surgical active treatment, in patients with testicular germ cells tumor (TGCT). Materials and methods: We retrospectively analyzed 52 patients who underwent surgery for TGCT from January 2009 to December 2014. All the patients were divided into two age groups: the Group A included children-adolescents from 18 months to 21 years old, while the Group B comprised young adults from 22 to 39 years old. Clinical, histopathological, therapeutic and follow-up data were collected. Results: Overall, 22 patients (42,3%) were enrolled in the Group A and 30 patients (57.7%) were categorized in the Group B. Inguinal orchiectomy was performed in all patients. Retroperitoneal lymphadenectomy was performed in 4 patients (7.7%). Post-surgical management differed based on clinical stage, resulting in active surveillance or adjuvant therapy. After an average 7 years follow-up period (range: 3.5-9.0 years), the overall survival rate is 100%. The relapse risk is significantly higher for the patients in the Group B, displaying a recurrence free-survival rate of 72% versus 95% (Group A); 11 relapses (21.1%) were recorded 2 years after surgery. Of these, 3 recurrences (12.0%) occurred in patients undergoing an active surveillance approach, while 8 (29.6%) in patients subjected to an active treatment. Conclusions: The excellent prognosis in both age groups confirms the high curability of this neoplasia. The active surveillance could represent an optimal option for low recurrence risk tumors. However, post-surgical treatments should be taken into consideration for TGCT with high risk factors, including tumor size, lymphovascular and rete testis invasion.

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Outcomes of surveillance versus adjuvant chemotherapy for patients with stage IA and IB nonseminomatous testicular germ cell tumors

Cited by 13 publications

References 28 publications

Sperm count in Swedish clinical stage I testicular cancer patients following adjuvant treatment

Sperm count in Swedish clinical stage I testicular cancer patients following adjuvant treatment

Primary Duodenal Carcinoma with Embryonal Carcinoma Features in a Young Man

Testicular germ cells tumors in adolescents and young adults: Management and outcomes from a single-center experience

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