HOME / PUBLICATIONS /

Two cycles of adjuvant carboplatin in stage I seminoma: 8-year experience by the Hellenic Cooperative Oncology Group (HECOG)

Citation:

Koutsoukos K, Tzannis K, Christodoulou C, Karavasilis V, Bakoyiannis C, Makatsoris T, Papandreou CN, Pectasides D, Dimopoulos MA, Bamias A. Two cycles of adjuvant carboplatin in stage I seminoma: 8-year experience by the Hellenic Cooperative Oncology Group (HECOG). World Journal of Urology [Internet]. 2016;34(6):853 - 857.

Abstract:

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.

Notes:

Cited By :1Export Date: 18 February 2017References: Fossa, S.D., Horwich, A., Russell, J.M., Optimal planning target volume for stage I testicular seminoma: a Medical Research Council randomised trial (1999) J Clin Oncol, 17, pp. 1146-1154. , COI: 1:STN:280:DC%2BD3c%2FivF2jsA%3D%3D, PID: 10561173;Schmoll, H.J., Souchon, R., Krege, S., European consensus on diagnosis and treatment of germ cell cancer: a report of the European Germ Cell Cancer Consensus Group (EGCCCG) (2004) Ann Oncol, 15, pp. 1377-1399. , COI: 1:STN:280:DC%2BD2cvhsVersw%3D%3D, PID: 15319245; Schmoll, H.J., Jordan, K., Huddart, R., ESMO Guidelines Working Group, Testicular seminoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up (2010) Ann Oncol, 21, pp. v140-v146. , PID: 20555065; Carver, B.S., Motzer, R.J., Kondagunta, G.V., Late relapse of testicular germ cell tumors (2005) Urol Oncol, 23, pp. 441-445. , PID: 16301125; Clinical practice guidelines in oncology: testicular cancer (2011) Version, 2, p. 2011. , www.nccn.org/professionals/physician_gls/pdf/testicular.pdf; Nuver, J., Smit, A.J., van der Meer, J., Acute chemotherapy-induced cardiovascular changes in patients with testicular cancer (2005) J Clin Oncol, 23 (36), pp. 9130-9137. , COI: 1:CAS:528:DC%2BD28Xnt1ygug%3D%3D, PID: 16301596; Travis, L.B., Fosså, S.D., Schonfeld, S.J., Second cancers among 40,576 testicular cancer patients: focus on long-term survivors (2005) J Natl Cancer Inst, 97 (18), pp. 1354-1365. , PID: 16174857; Haugnes, H.S., Bosl, G.J., Boer, H., Long-term and late effects of germ cell testicular cancer treatment and implications for follow-up (2012) J Clin Oncol, 30 (30), pp. 3752-3763. , PID: 23008318; Jones, W.G., Fosså, S.D., Mead, G.M., Randomized trial of 30 versus 20 Gy in the adjuvant treatment of stage I testicular seminoma: a report on Medical Research Council Trial TE18, European Organisation for the Research and Treatment of Cancer Trial 30942 (ISRCTN18525328) (2005) J Clin Oncol, 23, pp. 1200-1208. , PID: 15718317; Oliver, R.T., Mason, M.D., Mead, G.M., Radiotherapy versus single-dose carboplatin in adjuvant treatment of stage I seminoma: a randomised trial (2005) Lancet, 366, pp. 293-300. , COI: 1:CAS:528:DC%2BD2MXmsVWktbw%3D, PID: 16039331; Aparicio, J., Garcia del Muro, X., Maroto, P., Multicenter study evaluating a dual policy of postorchiectomy surveillance and selective adjuvant single-agent carboplatin for patients with clinical stage I seminoma (2003) Ann Oncol, 14, pp. 867-872. , COI: 1:STN:280:DC%2BD3s3mvFGntA%3D%3D, PID: 12796024; Brenner, D.J., Hall, E.J., Computed tomography: an increasing source of radiation exposure (2007) N Engl J Med, 357, pp. 2277-2284. , COI: 1:CAS:528:DC%2BD2sXhsVSlurfF, PID: 18046031; van Walraven, C., Fergusson, D., Earle, C., Association of diagnostic radiation exposure and second abdominal-pelvic malignancies after testicular cancer (2011) J Clin Oncol, 29, pp. 2883-2888. , PID: 21690479; Warde, P., Specht, L., Horwich, A., Prognostic factors for relapse in stage I seminoma managed by surveillance: a pooled analysis (2002) J Clin Oncol, 20, pp. 4448-4452. , PID: 12431967; Aparicio, J., Germà, J.R., García del Muro, X., Risk-adapted management for patients with clinical stage I seminoma: the Second Spanish Germ Cell Cancer Cooperative Group study (2005) J Clin Oncol, 23, pp. 8717-8723. , PID: 16260698; Bamias, A., Aravantinos, G., Deliveliotis, C., Two cycles of etoposide/cisplatin cured all patients with stage I testicular seminoma: risk-adapted protocol of the Hellenic Cooperative Oncology Group (2007) Urology, 70, pp. 1179-1183. , PID: 18158042; Horwich, A., Mason, M., Dearnaley, D.P., Use of carboplatin in germ cell tumors of the testis (1992) Semin Oncol, 19, pp. 72-77. , COI: 1:STN:280:DyaK3s%2FjtVyktg%3D%3D, PID: 1329224; Dieckmann, K.P., Krain, J., Küster, J., Brüggeboes, B., Adjuvant carboplatin treatment for seminoma clinical stage I (1996) J Cancer Res Clin Oncol, 122 (1), pp. 63-66. , COI: 1:CAS:528:DyaK28XhtFGqs70%3D, PID: 8543595; Cockcroft, D.W., Gault, M.H., Prediction of creatinine clearance from serum creatinine (1976) Nephron, 16 (1), pp. 31-41. , COI: 1:STN:280:DyaE28%2FnsF2isw%3D%3D, PID: 1244564; Oliver, R.T., Mead, G.M., Rustin, G.J., Randomized trial of carboplatin versus radiotherapy for stage I seminoma: mature results on relapse and contralateral testis cancer rates in MRC TE19/EORTC 30982 study (ISRCTN27163214) (2011) J Clin Oncol, 29, pp. 957-962. , COI: 1:CAS:528:DC%2BC3MXkslOhsLw%3D, PID: 21282539; Fossa, S.D., Horwich, A., Russell, J.M., Optimal planning target volume for stage I testicular seminoma: a Medical Research Council randomized trial (1999) J Clin Oncol, 17, pp. 1146-1154. , COI: 1:STN:280:DC%2BD3c%2FivF2jsA%3D%3D, PID: 10561173; Cohn-Cedermark, G., Stahl, O., Tandstad, T., SWENOTECA, Surveillance vs. adjuvant therapy of clinical stage I testicular tumors—a review and the SWENOTECA Experience (2015) Andrology, 3, pp. 102-110. , COI: 1:CAS:528:DC%2BC2MXjtF2qt7w%3D, PID: 25270123; Kollmannsberger, C., Tandstad, T., Philippe, L., Bedard, P., Cohn-Cedermark, G., Patterns of relapse in patients with clinical stage I testicular cancer managed with active surveillance (2015) J Clin Oncol, 22, pp. 51-57; Dieckmann, K.P., Brüggeboes, B., Adjuvant treatment of clinical stage I seminoma: Is a single course of carboplatin sufficient? (2000) Urology, 55 (1), pp. 102-106. , COI: 1:STN:280:DC%2BD3c7hvFSltg%3D%3D, PID: 10654903; Aparicio, J., Maroto, P., García del Muro, X., Risk-adapted treatment in clinical stage I testicular seminoma: the third Spanish Germ Cell Cancer Group study (2011) J Clin Oncol, 29, pp. 4677-4681. , PID: 22042940; Steiner, H., Scheiber, K., Berger, A.P., Retrospective multicentre study of carboplatin monotherapy for clinical stage I seminoma (2011) BJU Int, 107 (7), pp. 1074-1079. , COI: 1:CAS:528:DC%2BC3MXmvVantbg%3D, PID: 21438975; Oldenburg, J., Fosså, S.D., Nuver, J., Testicular seminoma and non-seminoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up (2013) Ann Oncol, 24, pp. vi125-vi132. , PID: 24078656; Albers, P., Albrecht, W., Algaba, F., EAU guidelines on testicular cancer: 2011 update (2011) Eur Urol, 60, pp. 304-319. , PID: 21632173; http://www.nccn.org, National Comprehensive Cancer Network NCCN (2012) Clinical Practice Guidelines in Oncology for Testicular Cancer, NCCN. (Version 1.2015)Aparicio, J., Maroto, P., Prognostic 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) (2014) Ann Oncol, 2014 (25), pp. 2173-2178; Chung, P., Daugaard, G., Tyldesley, S., Evaluation of a prognostic model for risk of relapse in stage I seminoma surveillance (2015) Cancer Med, 4 (1), pp. 155-160. , PID: 25236854; Warde, P., Gospodarowicz, M., Banerjee, D., Prognostic factors for relapse in stage I testicular seminoma treated with surveillance (1997) J Urol, 157, pp. 1705-1709. , COI: 1:STN:280:DyaK2s3ms1OrtQ%3D%3D, PID: 9112510; Pliarchopoulou, K., Pectasides, D., Late complications of chemotherapy in testicular cancer (2010) Cancer Treat Rev, 36 (3), pp. 262-267. , COI: 1:CAS:528:DC%2BC3cXksFChtrk%3D, PID: 20092952; Powles, T., Robinson, D., Shamash, J., The long-term risks of adjuvant carboplatin treatment for stage I seminoma of the testis (2008) Ann Oncol, 19, pp. 443-444. , COI: 1:STN:280:DC%2BD1c7ksVartA%3D%3D, PID: 18048383

Website