Advertisement

Controversies in the management of stage I seminoma: adjuvant carboplatin revisited

  • J. Aparicio
  • J. Terrasa
  • the Spanish Germ Cell Cancer Group
Correspondence

To the editor:

Systematic active surveillance (AS) and risk-adapted adjuvant chemotherapy (RAAC) with carboplatin have become the most widely used, standard options for patients with stage I testicular seminoma. In the absence of a randomized clinical trial comparing them, the selection of one of these two approaches is generally guided by national consensus, institutional preference and physician experience. In a recent Spanish Germ Cell Cancer Group (SGCCG) survey, 37 out of 38 responding centers confirmed the RAAC as their current management option. Interestingly, 16 centers used 2 courses of adjuvant carboplatin, 8 centers used 1 course, and 13 employed 1 or 2 courses depending on the number of risk factors present (unpublished data).

Two recent publications analyze the pros and cons of AS (against those of RAAC). Pieroracio et al. presented a critical review of 68 studies (including randomized, non-randomized comparative, single-arm studies and guideline statements) [1], whereas...

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants performed by any of the authors.

Informed consent

For this type of study formal consent is not required.

References

  1. 1.
    Pierorazio PM, Albers P, Black PC, Tandstad T, Heidenreich A, Nicolai N, Nichols C. Non-risk-adapted surveillance for stage I testicular cancer: critical review and summary. Eur Urol 2018.  https://doi.org/10.1016/j.eururo.2017.12.030. (Epub ahead of print).
  2. 2.
    van de Wetering RAW, Sleijfer S, Feldman DR, Funt SA, Bosl GJ, de Wit R. Controversies in the management of clinical stage I seminoma: carboplatin a decade in-time to start backing out. J Clin Oncol. 2018;36:837–40.CrossRefPubMedGoogle Scholar
  3. 3.
    Zagars GK, Ballo MT, Lee AK, Strom SS. Mortality after cure of testicular seminoma. J Clin Oncol. 2004;22:640–7.CrossRefPubMedGoogle Scholar
  4. 4.
    Oliver RT, Mead GM, Rustin GJM, et al. 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). J Clin Oncol. 2011;29:957–62.CrossRefPubMedGoogle Scholar
  5. 5.
    Mortensen MS, Bandak M, Kier MGG, et al. Surveillance versus adjuvant radiotherapy for patients with high-risk stage I seminoma. Cancer. 2017;123:1212–8.CrossRefPubMedGoogle Scholar
  6. 6.
    Aparicio J, Maroto P, García del Muro X, et al. 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). Ann Oncol. 2014;25:2173–8.CrossRefPubMedGoogle Scholar
  7. 7.
    Fehr M, Maranta AF, Reichegger H, Gillessen S, Cathomas R. Carboplatin dose based on actual renal function: no excess of acute haematotoxicity in adjuvant treatment in seminoma stage I. ESMO Open. 2018;3:e000320.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Tandstad T, Stahl O, Dahl O, et al. Treatment of stage I seminoma, with one course of adjuvant carboplatin or surveillance, risk-adapted recommendations implementing patient autonomy: a report from the Swedish and Norwegian Testicular Cancer Group (SWENOTECA). Ann Oncol. 2016;27:1299–304.CrossRefPubMedGoogle Scholar
  9. 9.
    Dieckmann KP, Dralle-Filiz I, Matthies C, et al. German testicular cancer study group: testicular seminoma clinical stage 1: treatment outcome on a routine care level. J Cancer Res Clin Oncol. 2016;142:1599–607.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Federación de Sociedades Españolas de Oncología (FESEO) 2018

Authors and Affiliations

  1. 1.Servicio de Oncología MédicaHospital Universitario y Politécnico La FeValenciaSpain
  2. 2.Servicio de Oncología MédicaHospital Universitario Son EspasesPalma de MallorcaSpain

Personalised recommendations