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carboplatin, 8 centers used 1 course, and 13 employed 1 or 2 courses depending on the number of risk factors present (unpublished data).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...
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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.
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