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Controversies in the management of clinical stage I testicular seminoma
INTRODUCTION: Following orchiectomy patients with clinical stage I (CSI) testicular seminoma may be managed by active surveillance (AS) or adjuvant treatment (radiotherapy or chemotherapy). In view of the published data on long-term toxicity, mainly second malignant neoplasms (SMNs), adjuvant radiot...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Polish Urological Association
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4846723/ https://www.ncbi.nlm.nih.gov/pubmed/27123323 http://dx.doi.org/10.5173/ceju.2016.699 |
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author | Ondrusova, Martina Balogova, Sona Lehotska, Viera Kajo, Karol Mrinakova, Bela Ondrus, Dalibor |
author_facet | Ondrusova, Martina Balogova, Sona Lehotska, Viera Kajo, Karol Mrinakova, Bela Ondrus, Dalibor |
author_sort | Ondrusova, Martina |
collection | PubMed |
description | INTRODUCTION: Following orchiectomy patients with clinical stage I (CSI) testicular seminoma may be managed by active surveillance (AS) or adjuvant treatment (radiotherapy or chemotherapy). In view of the published data on long-term toxicity, mainly second malignant neoplasms (SMNs), adjuvant radiotherapy (ART) is currently no longer recommended as adjuvant therapy for these patients. The purpose of our recent study was to compare the impact of two selected treatment approaches – AS versus adjuvant chemotherapy (ACT) on survival in patients with CSI testicular seminoma. MATERIAL AND METHODS: The cross-sectional study analyzed a total of 106 patients collected at a single centre between 4/2008–8/2015, with CSI testicular seminoma, stratified into two groups according to risk-adapted therapeutic approaches. RESULTS: In group A (low-risk), consisting of 84 patients, who underwent AS, relapse occurred in 10 (11.9%) patients after a mean follow-up of 13.8 months. In group B (high-risk), consisting of 22 patients, who were treated with ACT, relapse occurred in two (9.1%) patients after a mean follow-up of 13.8 months. Overall survival of patients in both groups was 100% with a mean follow-up of 25.3 months. The statistically significant difference in progression-free survival (PFS) between these two groups was not found. CONCLUSIONS: ACT seems to be adequate treatment for patients with high-risk of relapse, as well as AS for those with low-risk of relapse. Despite its excellent prognosis, optimal management of CSI testicular seminoma remains controversial, with variations in expert opinion and international guidelines. |
format | Online Article Text |
id | pubmed-4846723 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Polish Urological Association |
record_format | MEDLINE/PubMed |
spelling | pubmed-48467232016-04-27 Controversies in the management of clinical stage I testicular seminoma Ondrusova, Martina Balogova, Sona Lehotska, Viera Kajo, Karol Mrinakova, Bela Ondrus, Dalibor Cent European J Urol Original Paper INTRODUCTION: Following orchiectomy patients with clinical stage I (CSI) testicular seminoma may be managed by active surveillance (AS) or adjuvant treatment (radiotherapy or chemotherapy). In view of the published data on long-term toxicity, mainly second malignant neoplasms (SMNs), adjuvant radiotherapy (ART) is currently no longer recommended as adjuvant therapy for these patients. The purpose of our recent study was to compare the impact of two selected treatment approaches – AS versus adjuvant chemotherapy (ACT) on survival in patients with CSI testicular seminoma. MATERIAL AND METHODS: The cross-sectional study analyzed a total of 106 patients collected at a single centre between 4/2008–8/2015, with CSI testicular seminoma, stratified into two groups according to risk-adapted therapeutic approaches. RESULTS: In group A (low-risk), consisting of 84 patients, who underwent AS, relapse occurred in 10 (11.9%) patients after a mean follow-up of 13.8 months. In group B (high-risk), consisting of 22 patients, who were treated with ACT, relapse occurred in two (9.1%) patients after a mean follow-up of 13.8 months. Overall survival of patients in both groups was 100% with a mean follow-up of 25.3 months. The statistically significant difference in progression-free survival (PFS) between these two groups was not found. CONCLUSIONS: ACT seems to be adequate treatment for patients with high-risk of relapse, as well as AS for those with low-risk of relapse. Despite its excellent prognosis, optimal management of CSI testicular seminoma remains controversial, with variations in expert opinion and international guidelines. Polish Urological Association 2016-01-20 2016 /pmc/articles/PMC4846723/ /pubmed/27123323 http://dx.doi.org/10.5173/ceju.2016.699 Text en Copyright by Polish Urological Association http://creativecommons.org/licenses/by-nc-sa/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license. |
spellingShingle | Original Paper Ondrusova, Martina Balogova, Sona Lehotska, Viera Kajo, Karol Mrinakova, Bela Ondrus, Dalibor Controversies in the management of clinical stage I testicular seminoma |
title | Controversies in the management of clinical stage I testicular seminoma |
title_full | Controversies in the management of clinical stage I testicular seminoma |
title_fullStr | Controversies in the management of clinical stage I testicular seminoma |
title_full_unstemmed | Controversies in the management of clinical stage I testicular seminoma |
title_short | Controversies in the management of clinical stage I testicular seminoma |
title_sort | controversies in the management of clinical stage i testicular seminoma |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4846723/ https://www.ncbi.nlm.nih.gov/pubmed/27123323 http://dx.doi.org/10.5173/ceju.2016.699 |
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