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Treatment of early stage testicular seminoma
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Treatment of early stage testicular seminoma
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Journal Article
Treatment of early stage testicular seminoma
2001
Overview
Stage I and IIA/B testicular seminoma represent approximately 45% of all testicular germ cell tumours. Due to the availability of highly efficient salvage treatment, the disease-specific survival in stage I seminoma is approximately 100%, irrespective of the choice of adjuvant treatment. Radiotherapy with 26 Gy to the paraaortic/paracaval lymph nodes yields excellent cure rates of 95 98% with a favourable profile of acute and late toxicity. Likewise, phase-II trials with single-agent carboplatinum systemic treatment have demonstrated a rate of relapse of 3-4% on average. However, carboplatinum chemotherapy has to be regarded as experimental until data of phase-III trials are available. Surveillance in stage I disease is conflicted with a rate of relapse of approximately 20%. However, 80% of the patients will avoid potentially toxic overtreatment by the watch-and-wait policy. In stage IIA/B seminoma, \"dogleg\" radiotherapy with 30 Gy and 36 Gy, respectively, provides high cure rates of 90-95%. Those patients relapsing will be salvaged in almost 100% of cases. Testicular intraepithelial neoplasia (TIN) is the common precursor lesion of testicular germ cell tumours except for spermatocytic seminoma. In case of TIN in a single testis or bilateral TIN, local radiotherapy with 18 Gy is recommended as standard treatment.
Publisher
Springer,Springer Nature B.V,Springer-Verlag
Subject
Antineoplastic Agents - therapeutic use
/ Biological and medical sciences
/ Carboplatin - therapeutic use
/ Gynecology. Andrology. Obstetrics
/ Humans
/ Male
/ Review
/ Seminoma
/ Testes
/ Testicular Neoplasms - classification
/ Testicular Neoplasms - drug therapy
/ Testicular Neoplasms - pathology
/ Testicular Neoplasms - radiotherapy
/ Toxicity
/ Tumors
