TY - JOUR
TI - Two cycles of adjuvant carboplatin in stage I seminoma: 8-year experience by the Hellenic Cooperative Oncology Group (HECOG)
AU - Koutsoukos, K.
AU - Tzannis, K.
AU - Christodoulou, C.
AU - Karavasilis, V.
AU - Bakoyiannis, C.
AU - Makatsoris, T.
AU - Papandreou, C.N.
AU - Pectasides, D.
AU - Dimopoulos, M.A.
AU - Bamias, A.
JO - World Journal of Urology
PY - 2016
VL - 34
TODO - 6
SP - 853-857
PB - Springer-Verlag
SN - 0724-4983, 1433-8726
TODO - 10.1007/s00345-015-1695-0
TODO - antineoplastic agent;  carboplatin;  cisplatin;  etoposide, adjuvant chemotherapy;  adult;  cancer staging;  clinical trial;  comparative study;  human;  male;  multicenter study;  pathology;  retrospective study;  seminoma;  Testicular Neoplasms;  time factor, Adult;  Antineoplastic Agents;  Antineoplastic Combined Chemotherapy Protocols;  Carboplatin;  Chemotherapy, Adjuvant;  Cisplatin;  Etoposide;  Humans;  Male;  Neoplasm Staging;  Retrospective Studies;  Seminoma;  Testicular Neoplasms;  Time Factors
TODO - Purpose: Following the establishment of adjuvant carboplatin in stage I testicular seminoma as a standard, we adopted this treatment for all stage I seminoma patients. We report our 8-year experience and compare these results with our previous adjuvant etoposide/cisplatin (EP) strategy. Patients and methods: Patients with stage I seminoma, treated with adjuvant carboplatin and with a minimum follow-up of 1 year, were included. Two cycles of carboplatin [area under the curve (AUC) 6] were administered. Results: A total of 138 patients with median age of 34 years, treated from September 2003 to December 2011, were selected. There were 5 relapses [5-year relapse-free rate (RFR) 96.8 % (95 % confidence interval 91.6–98.8)]: 3 relapses at retroperitoneal lymph nodes, 1 relapse at the adrenal gland, and 1 isolated brain metastasis. Four patients with relapse were cured with salvage chemotherapy. All patients with relapse had tumor diameter ≥4 cm and/or age ≤34 years. Patients with at least 1 of the above risk factors (n = 111) had a significantly higher relapse rate compared with a similar population (n = 64) treated with 2 cycles of adjuvant EP: 5-year RFR was 95 % (SE 2 %) versus 100 % (SE 0 %), (p = 0.067). Conclusions: Age and tumor diameter were associated with relapse in stage I seminoma treated with adjuvant carboplatin. Although adjuvant carboplatin in patients with age ≤34 and/or tumor diameter ≥4 cm is associated with higher relapse rates than EP, the prognosis of these patients is excellent, and therefore, the use of less toxic treatment is justified. © 2015, Springer-Verlag Berlin Heidelberg.
ER -