Patterns of relapse and treatment outcome after active surveillance or adjuvant carboplatin for stage I seminoma: a retrospective study of the Spanish Germ Cell Cancer Group

Aparicio, Jorge; Muro, Xavier García del; Maroto, Pablo; Terrasa, Josefa; Castellano, Daniel; Bastús, R.; Gumà, Josep; Sagastibeltza, N; Durán, Ignacio; Ochenduszko, Sebastián; Meana, J. A.; García-Sánchez, José; Arranz, José Ángel; Gironés, Regina; Germà, J.R.

doi:10.1007/s12094-020-02393-9

Cited by 7 publications

(9 citation statements)

References 12 publications

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“…37 However, non-randomized data suggest a reduction in relapses with two cycles (1.5-3% vs. 5%). 38,39 As well, population-based SWENOTECA data shows relatively small risk reductions with only one cycle of carboplatin compared to surveillance, especially with higher-risk patients (relapse rate 2.2% vs. 4.0% in lower-risk patients and 9.3% vs. 15.5% in higher-risk patients). 21 There are many potential disadvantages with this adjuvant approach.…”

Section: Adjuvant Chemotherapymentioning

confidence: 97%

Canadian Urological Association consensus guideline: Management of testicular germ cell cancer

Hamilton

Canil

Shrem

et al. 2022

CUAJ

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At the Canadian GCT meeting held in Toronto in 2018, Canadian GCT providers prioritized updating the Canadian consensus document, which was last updated in 2010. 7 MethodsA multidisciplinary group of Canadian testicular cancer experts (nine medical oncologists, five uro-oncologists, two radiation oncologists, one genitourinary pathologist, and one genitourinary radiologist) participated in updating this guideline. Participants were assigned stage-specific topics to update and the project leads (RH, CC, LW) participated in updating all topics. Five individual stage-specific meetings with each subgroup of experts were conducted in April 2021 to discuss and develop key recommendations. Once recommendations were compiled, all participants voted via SurveyMonkey to determine their level of agreement. Modifying methods used by the European Association of Urology and European Society for Medical Oncology Guidelines Committees, each recommendation was followed by a five-point Likert scale: completely disagree, somewhat disagree, undecided, somewhat agree, completely agree, abstain (out of scope of my practice and/or I don't feel comfortable answering). 8 A priori, agreement was defined as ≥75% of experts voting somewhat agree or completely agree. Results from this initial vote are shown in Supplementary Figure 1 (available at cuaj.ca).In June 2021, a full group virtual meeting was held to discuss one recommendation that did not reach agreement, along with 22 other recommendations that, despite ≥75% agreement, some experts had indicated disagreement or undecided opinions. Proposed changes were made accordingly, including the creation of one new recommendation. In July 2021, a second and final vote was conducted including all of the recommendations where any changes had been proposed. Agreement was achieved in all recommendations. Throughout the guideline, after each recommendation, the percent of experts who voted "completely agree" or "somewhat agree" with each statement is shown in parentheses.* Bone.scan.and.brain.imaging.in.patients.with.symptoms.or.poor.prognosis.metastatic. disease..CT:..computed.tomography.

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Section: Adjuvant Chemotherapymentioning

confidence: 97%

Canadian Urological Association consensus guideline: Management of testicular germ cell cancer

Hamilton

Canil

Shrem

et al. 2022

CUAJ

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“…Data on the late toxicities of carboplatin have been limited. Recent reports have raised concerns of rates of secondary malignancy, as well as carboplatin-induced cisplatin resistance [39,40]. It is important to note, though, that event rates and follow-up time in these studies were limited, and therefore results are more speculative.…”

Section: Adjuvant Chemotherapymentioning

confidence: 98%

Management of stage I testicular cancer

Padayachee

Clark

Warde

et al. 2021

Current Opinion in Urology

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Purpose of reviewTesticular cancer is the most common solid malignancy amongst young men, and a large proportion present with stage I disease. The options for management following radical orchiectomy are multifold. We review here approaches to treatment in this setting, providing an update on recent publications. Recent findingsAt Princess Margaret Cancer Centre, we maintain a nonrisk adapted active surveillance approach. With a dedicated surveillance program using low-dose computed tomography imaging, patients are appropriately identified early for treatment on relapse. There are ongoing investigations into minimizing toxicities of treatments for relapse, and in particular, retroperitoneal lymph node dissection (RPLND) presents an attractive alternative. This, though, remains investigational in the setting of seminoma.

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“…Approximately 3–20% of these patients experience relapse at a median of 14–21 mo after orchiectomy [2] , [3] , [4] . After surveillance, relapse is observed in 6–20% of cases, whereas relapse after adjuvant treatment is observed in 3–6% [2] , [3] , [4] , [5] . Approximately 75–95% of all recurrences can be observed within the first 2–3 yr and >95% within 5 yr [6] , [2] , [7] , [8] , [9] .…”

Section: Evidence Synthesismentioning

confidence: 99%

“…Approximately 75–95% of all recurrences can be observed within the first 2–3 yr and >95% within 5 yr [6] , [2] , [7] , [8] , [9] . For nearly 90% of relapses, recurrence is observed in the retroperitoneum, for which an abdominal CT scan is the most common modality for detection [2] , [5] , [10] . By contrast, recurrence detected via clinical examination, chest X-ray, or STMs (bHCG, AFP, or LDH) alone is observed in 0–5%, 0%, and 5–10% (bHCG 3–11%, AFP 0–2%) of cases, respectively [2] , [7] , [9] , [11] .…”

Section: Evidence Synthesismentioning

confidence: 99%

“…Although seminomatous GCT by definition does not produce AFP, this marker is assessed during follow-up as a few patients initially diagnosed with seminoma may experience recurrence with an AFP-producing nonseminomatous GCT. Isolated pelvic metastases are observed in <1% of patients overall and 5% of patients with recurrence [5] , [10] , [12] , [13] .…”

Section: Evidence Synthesismentioning

confidence: 99%

See 1 more Smart Citation

Oncological Follow-up Strategies for Testicular Germ Cell Tumours: A Narrative Review

Kaufmann

Antonelli

Albers

et al. 2022

European Urology Open Science

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Patterns of relapse and treatment outcome after active surveillance or adjuvant carboplatin for stage I seminoma: a retrospective study of the Spanish Germ Cell Cancer Group

Cited by 7 publications

References 12 publications

Canadian Urological Association consensus guideline: Management of testicular germ cell cancer

Canadian Urological Association consensus guideline: Management of testicular germ cell cancer

Management of stage I testicular cancer

Oncological Follow-up Strategies for Testicular Germ Cell Tumours: A Narrative Review

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