A Risk-Adapted Approach to Patients with Stage I Seminoma according to the Status of Rete Testis: The Fourth Spanish Germ Cell Cancer Group Study
Por:
Aparicio J, Sánchez-Muñoz A, Gumà J, Domenech M, Meana JA, García-Sánchez J, Bastús R, Gironés R, González-Billalabeitia E, Sagastibelza N, Ochenduszko S, Sánchez A, Terrasa J, Germà-Lluch JR and García Del Muro X
Publicada:
1 ene 2018
Resumen:
Objective: The aim of this study was to assess a risk-adapted strategy for stage I seminoma guided by the presence of rete testis invasion. Methods: Between January 2013 and December 2015, a total of 135 consecutive patients with stage I seminoma from 18 Spanish tertiary hospitals were included in a prospective multicenter study. Median patient age was 38 years (range 22-60). Preoperative beta-human chorionic gonadotropin was elevated in 9.6% of patients. Rete testis invasion was present in 47.4% of patients. After orchiectomy, subjects with rete testis invasion were treated with 2 courses of adjuvant carboplatin (area under the curve of 7, with 21day interval). Those without this risk factor were managed by surveillance. Disease-free survival (DFS) and overall survival (OS) were estimated with the Kaplan-Meier method. Results: After a median follow-up time of 33 months, only 6 relapses were recorded (5 on surveillance, 1 after carboplatin). These cases were rescued with BEP or EP chemotherapy, and all 135 patients are currently disease free without sequelae. Threeyear DFS was 92.0 and 98.2% for patients on surveillance and after carboplatin, respectively. Three-year OS was 100%. Conclusion: A risk-adapted approach based on rete testis invasion as a single risk factor is feasible and yielded an excellent outcome with a 3-year DFS of 94.9%. (C) 2018 S. Karger AG, Basel
Filiaciones:
Aparicio J:
Medical Oncology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spain
Sánchez-Muñoz A:
Medical Oncology Department, Investigación Clínica y Traslacional en Cáncer/Instituto de Investigaciones Biomédicas de Málaga (IBIMA)/Hospitales Universitarios Regional y Virgen de la Victoria, Málaga, Spain
Gumà J:
Medical Oncology Department, Hospital Universitario Sant Joan, URV, IISPV, Reus, Spain
Domenech M:
Medical Oncology Department, Hospital Althaia, Manresa, Spain
:
Medical Oncology Department, Hospital General, Alicante, Spain
García-Sánchez J:
Medical Oncology Department, Hospital Arnau de Vilanova, Valencia, Spain
Bastús R:
Medical Oncology Department, Hospital Universitari Mútua Terrassa, Terrassa, Spain
Gironés R:
Medical Oncology Department, Hospital Lluis Alcanyís, Xátiva, Spain
González-Billalabeitia E:
Medical Oncology Department, Hospital Universitario Morales Meseguer-IMIB, UCAM, Murcia, Spain
Sagastibelza N:
Medical Oncology Department, Hospital Donostia, San Sebastián, Spain
Ochenduszko S:
Medical Oncology Department, Hospital Universitario Dr Peset, Valencia, Spain
Sánchez A:
Medical Oncology Department, Hospital Provincial, Castellón, Spain
Terrasa J:
Medical Oncology Department, Hospital Son Espases, Palma de Mallorca, Spain
Germà-Lluch JR:
Medical Oncology Department, Institut Catalá d'Oncologia, IDIBELL, L'Hospitalet de Llobregat, L'Hospitalet de Llobregat, Spain
García Del Muro X:
Medical Oncology Department, Institut Catalá d'Oncologia, IDIBELL, L'Hospitalet de Llobregat, L'Hospitalet de Llobregat, Spain
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