Treatment of Stage I Seminoma
DOI:
https://doi.org/10.17140/CSMMOJ-2-111Keywords:
Seminoma stage I surveillance, Radiotherapy, Tumors, TreatmentAbstract
Stage I testicular seminoma is a curable condition. The primary treatment is high inguinal orchiectomy. The treatment options after surgery includes radiotherapy, chemotherapy with single agent carboplatin and active surveillance. Radiotherapy has evolved over the past decades with reduced treatment volume and radiation dose without compromising the outcome. Para aortic strip radiation 20 Gy in 10 fractions is equivalent to single agent carboplatin. Active surveillance is an acceptable approach for patients without adverse factors. There is no data comparing treatment versus active surveillance till date. This article reviews the evidences for each approach.
References
Ferlay JSI, Ervik M, Dikshit R, et al. GLOBOCAN 2012 v1.0, Cancer incidence and mortality worldwide: IARC cancer base no. 11. Lyon, France: International agency for research on can-cer, 2013.
Ruf CG, Isbarn H, Wagner W, Fisch M, Matthies C, Dieck-mann KP. Changes in epidemiologic features of testicular germ cell cancer: age at diagnosis and relative frequency of seminoma are constantly and significantly increasing. Urologic oncology. 2014; 32: 33.e1-6. doi: 10.1016/j.urolonc.2012.12.002
Oliver RT, Mead GM, Rustin GJ, et al. Randomized trial of carboplatin versus radiotherapy for stage I seminoma: ma-ture results on relapse and contralateral testis cancer rates in MRC TE19/EORTC 30982 study (ISRCTN27163214). Jour-nal of clinical oncology: official journal of the American So-ciety of Clinical Oncology. 2011; 29: 957-962. doi: 10.1200/ JCO.2009.26.4655
Warde P, Gospodarowicz MK, Panzarella T, et al. Stage I testicular seminoma: results of adjuvant irradiation and surveil-lance. Journal of Clinical Oncology. 1995; 13: 2255-2262.
Mead GM, Fossa SD, Oliver RT, et al. Randomized trials in 2466 patients with stage I seminoma: patterns of relapse and follow-up. Journal of the National Cancer Institute. 2011; 103: 241-249.
Warde P, Specht L, Horwich A, et al. Prognostic factors for relapse in stage I seminoma managed by surveillance: a pooled analysis. Journal of clinical oncology: official journal of the American Society of Clinical Oncology. 2002; 20: 4448-4452. doi: 10.1200/JCO.2002.01.038
Aparicio J, Maroto P, Garcia Del Muro X, et al. Prognos-tic factors for relapse in stage I seminoma: a new nomogram derived from three consecutive, risk-adapted studies from the spanish germ cell cancer group (SGCCG). Annals of oncology: official journal of the European Society for Medical Oncology/ ESMO. 2014, 25: 2173-2178. doi: 10.1093/annonc/mdu437
Chung P, Daugaard G, Tyldesley S, et al. Evaluation of a prog-nostic model for risk of relapse in stage I seminoma surveil-lance. Cancer Med. 2015; 4(1): 155-160. doi: 10.1002/cam4.324
Mortensen MS, Lauritsen J, Gundgaard MG, et al. A nation-wide cohort study of stage I seminoma patients followed on a surveillance program. European urology. 2014; 66: 1172-1178. doi: 10.1016/j.eururo.2014.07.001
Aparicio J, Germa JR, Garcia del Muro X, et al. Risk-adapt-ed management for patients with clinical stage I seminoma: the second spanish germ cell cancer cooperative group study. Jour-nal of clinical oncology: official journal of the American Soci-ety of Clinical Oncology. 2005; 23: 8717-8723. doi: 10.1200/ JCO.2005.01.9810
Aparicio J, Maroto P, del Muro XG, et al. Risk-adapted treat-ment in clinical stage I testicular seminoma: the third spanish germ cell cancer group study. Journal of clinical oncology: offi-cial journal of the American Society of Clinical Oncology. 2011; 29: 4677-4681. doi: 10.1200/JCO.2011.36.0503
Chung P, Parker C, Panzarella T, et al. Surveillance in stage I testicular seminoma-risk of late relapse. The Canadian journal of urology. 2002; 9: 1637-1640.
Peckham MJ, Brada M. Surveillance following orchidec-tomy for stage I testicular cancer. International journal of an-drology. 1987; 10: 247-254. doi: 10.1111/j.1365-2605.1987. tb00190.x
Cummins S, Yau T, Huddart R, Dearnaley D, Horwich A. Surveillance in stage I seminoma patients: a long-term assess-ment. European urology. 2010; 57: 673-678. doi: 10.1016/j. eururo.2009.06.006
Endo T, Kawai K, Kamba T, et al. Risk factors for loss to follow-up during active surveillance of patients with Stage I seminoma. Jpn J Clin Oncol. 2014; 44: 355-359. doi: 10.1093/ jjco/hyu001
Kollmannsberger C, Tandstad T, Bedard PL, et al. Patterns of relapse in patients with clinical stage I testicular cancer managed with active surveillance. Journal of clinical oncology: official journal of the American Society of Clinical Oncology. 2015. doi: 10.1200/JCO.2014.56.2116
van As NJ, Gilbert DC, Money-Kyrle J, et al. Evidence-based pragmatic guidelines for the follow-up of testicular cancer: opti-mising the detection of relapse. British journal of cancer. 2008; 98: 1894-1902. doi: 10.1038/sj.bjc.6604280
Mok G, Warde P. Management of stage I testicular semi-noma. Hematology/oncology clinics of North America. 2011; 25: 503-516.
Catton C. Princess margaret cancer centre clinical practice guidelines. UHN. 2012. Available at: http://www.uhn.ca/Prin-cessMargaret/Health_Professionals/Programs_Departments/ Genitourinary_GU/Documents/CPG_GU_Testis.pdf
Tolan S, Vesprini D, Jewett MA, et al. No role for routine chest radiography in stage I seminoma surveillance. European urology. 2010; 57: 474-479.
Venkitaraman R, Johnson B, Huddart RA, Parker CC, Hor-wich A, Dearnaley DP. The utility of lactate dehydrogenase in the follow-up of testicular germ cell tumours. BJU international. 2007; 100: 30-32.
Vesprini D, Chung P, Tolan S, et al. Utility of serum tumor markers during surveillance for stage I seminoma. Cancer. 2012, 118: 5245-5250. doi: 10.1002/cncr.27539
Cafferty FH, Gabe R, Huddart RA, et al. UK management practices in stage I seminoma and the Medical Research Coun-cil Trial of Imaging and Schedule in Seminoma Testis man-aged with surveillance. Clinical oncology. 2012; 24: 25-29. doi: 10.1016/j.clon.2011.09.005
Fossa SD, Horwich A, Russell JM, et al. Optimal plan-ning target volume for stage I testicular seminoma: a medical research council randomized trial. Medical research council testicular tumor working group. Journal of clinical oncology: official journal of the American Society of Clinical Oncology. 1999; 17: 1146.
Jones WG, Fossa SD, Mead GM, et al. Randomized trial of 30 versus 20 Gy in the adjuvant treatment of stage I testicu-lar seminoma: a report on medical research council trial TE18, European organisation for the research and treatment of cancer trial 30942 (ISRCTN18525328). Journal of clinical oncology: official journal of the American Society of Clinical Oncology. 2005; 23: 1200-1208. doi: 10.1200/JCO.2005.08.003
Cohn-Cedermark G, Stahl O, Tandstad T. Surveillance vs. adjuvant therapy of clinical stage I testicular tumors - a review and the SWENOTECA experience. Andrology. 2015; 102-110. doi: 10.1111/andr.280
Hallemeier CL, Choo R, Davis BJ, Leibovich BC, Costello BA, Pisansky TM. Excellent long-term disease control with mod-ern radiotherapy techniques for stage I testicular seminoma-the mayo clinic experience. Urologic oncology. 2014; 32: 24.e1-6.
Horwich A, Fossa SD, Huddart R, et al. Second cancer risk and mortality in men treated with radiotherapy for stage I seminoma. British journal of cancer. 2014; 110: 256-263. doi: 10.1038/bjc.2013.551
Lewinshtein D, Gulati R, Nelson PS, Porter CR. Incidence of second malignancies after external beam radiotherapy for clini-cal stage I testicular seminoma. BJU international. 2012; 109: 706-712. doi: 10.1111/j.1464-410X.2011.10424.x
Beard CJ, Travis LB, Chen MH, et al. Outcomes in stage I testicular seminoma: a population-based study of 9193 patients. Cancer. 2013; 119: 2771-2777. doi: 10.1002/cncr.28086
Cathomas R, Klingbiel D, Geldart TR, et al. Relevant risk of carboplatin underdosing in cancer patients with normal renal function using estimated GFR: lessons from a stage I seminoma cohort. Annals of oncology: official journal of the European So-ciety for Medical Oncology/ESMO. 2014; 25: 1591-1597. doi: 10.1093/annonc/mdu129
Kleinschmidt K, Dieckmann KP, Georgiew A, Loy V, Weiss-bach L. Chemotherapy is of limited efficacy in the control of contralateral testicular intraepithelial neoplasia in patients with testicular germ cell cancer. Oncology. 2009; 77: 33-39. doi: 10.1159/000218202
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
All content published in Cancer Studies and Molecular Medicine (CSMM) is licensed under the Creative Commons Attribution 4.0 International License (CC BY 4.0). This license allows anyone to copy, distribute, transmit, and adapt the work — including for commercial purposes — provided appropriate credit is given to the original author(s) and source.
