Testicular cancer: Optimal management of stage I seminoma in 2015

@article{Toner2015TesticularCO,
  title={Testicular cancer: Optimal management of stage I seminoma in 2015},
  author={Guy C. Toner},
  journal={Nature Reviews Urology},
  year={2015},
  volume={12},
  pages={249-251}
}
  • G. Toner
  • Published 1 May 2015
  • Medicine
  • Nature Reviews Urology
Despite its excellent prognosis, optimal management of stage I seminoma remains controversial, with variations in expert opinion and international guidelines, particularly in terms of uncertainty regarding long-term treatment complications. Recent population-based reports shed new light on the subject, and help clarify the important, unresolved clinical questions that require further research to answer. 
2 Citations

Topics from this paper

Controversies in the management of clinical stage I testicular seminoma
TLDR
ACT seems to be adequate treatment for patients with high-risk of relapse, as well as AS for those with low- risk of relapse in patients with CSI testicular seminoma.
Decrease in radiation therapy rates in patients with stage I seminoma: a population-based study
TLDR
Adjuvant radiotherapy to these sites decreases the risk of metastasis, and therefore, became the standard adjuvant treatment for stage I seminoma for decades.

References

SHOWING 1-10 OF 12 REFERENCES
Optimal management of clinical stage I testis cancer: one size does not fit all.
  • R. de Wit, G. Bosl
  • Medicine
    Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 2013
The optimal management for clinical stage (CS) I testicular germ cell tumors (GCTs) is controversial. Simply put, the efficacy of cisplatin-based chemotherapy cures nearly 100% of both seminoma (SEM)
Risk-adapted treatment in clinical stage I testicular seminoma: the third Spanish Germ Cell Cancer Group study.
  • J. Aparicio, P. Maroto, +15 authors J. Germà
  • Medicine
    Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 2011
TLDR
It is confirmed that a risk-adapted approach is effective for stage I seminoma, and adjuvant carboplatin seems adequate treatment for patients with 2 risk criteria, as is active surveillance for those with 0 to one risk factors.
Surveillance vs. adjuvant therapy of clinical stage I testicular tumors – a review and the SWENOTECA experience
TLDR
The aims of the Swedish and Norwegian Testicular Cancer Group (SWENOTECA) studies for CS I non‐seminoma (NS) and seminoma (S) have been to reduce treatment intensity while maintaining high survival rates, reduce the number of patients needing salvage treatment and implement patient autonomy with regard to adjuvant treatment.
Treatment preferences in stage IA and IB testicular seminoma: multicenter study of Anatolian Society of Medical Oncology
TLDR
It is indicated that adjuvant treatment with carboplatin or RT is associated with improved DFS compared with surveillance for men with stage I testicular seminoma after orchiectomy and the treatment strategy is an important prognostic indicator for DFS and a predictive factor for relapse.
Personalizing, not patronizing: the case for patient autonomy by unbiased presentation of management options in stage I testicular cancer.
TLDR
An overview about risk factors for relapse, potential benefits and harms of adjuvant chemotherapy and active surveillance and a rationale for involving patients in individualized decision making about their treatment rather than adopting a uniform recommendation for all are provided.
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).
  • R. Oliver, G. Mead, +6 authors S. Stenning
  • Medicine
    Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 2011
TLDR
These updated results confirm the noninferiority of single dose carboplatin (at 7 × AUC dose) versus RT in terms of RFR and establish a statistically significant reduction in the medium term of risk of second GCT produced by this treatment.
Evaluation of a prognostic model for risk of relapse in stage I seminoma surveillance
TLDR
Primary tumor size retained prognostic importance and a scale of relapse risk based on the unit increment of tumor size was developed to help guide patients and clinicians in decision making.
A nationwide cohort study of stage I seminoma patients followed on a surveillance program.
TLDR
In the world's largest study of stage I seminoma patients, surveillance was found to be a safe alternative to adjuvant therapies and tumor size was a significant factor for relapse.
Second cancers among 40,576 testicular cancer patients: focus on long-term survivors.
TLDR
Testicular cancer survivors are at statistically significantly increased risk of solid tumors for at least 35 years after treatment, and young patients may experience high levels of risk as they reach older ages.
Active surveillance is the preferred approach to clinical stage I testicular cancer.
TLDR
This research highlights the need to understand more fully the role of Epstein-Barr virus in the development of central giant cell granuloma, a type of cancer that is difficult to treat with traditional chemotherapy.
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