Controversies in the management of stage I seminoma: adjuvant carboplatin revisited
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carboplatin, 8 centers used 1 course, and 13 employed 1 or 2 courses depending on the number of risk factors present (unpublished data).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) , whereas...
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
This article does not contain any studies with human participants performed by any of the authors.
For this type of study formal consent is not required.
- 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).
- 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.CrossRefGoogle Scholar