Universität zu Köln

Hiester, Andreas, Fingerhut, Anna, Niegisch, Gunter, Siener, Roswitha, Krege, Susanne, Schmelz, Hans-Ulrich, Dieckmann, Klaus-Peter, Heidenreich, Axel, Kwasny, Peter, Pechoel, Maik, Lehmann, Jan, Kliesch, Sabine, Koehrmann, Kai-Uwe, Fimmers, Rolf, Loy, Volker, Wittekind, Christian, Hartmann, Michael and Albers, Peter (2021). Late toxicities and recurrences in patients with clinical stage I non-seminomatous germ cell tumours after 1 cycle of adjuvant bleomycin, etoposide and cisplatin versus primary retroperitoneal lymph node dissection- A 13-year follow-up analysis of a phase III trial cohort. Eur. J. Cancer, 155. S. 64 - 73. OXFORD: ELSEVIER SCI LTD. ISSN 1879-0852

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Abstract

Background: One cycle of adjuvant chemotherapy with bleomycin, etoposide and cisplatin (BEP) has shown superiority in recurrence-free survival over retroperitoneal lymph node dissection (RPLND) in patients with clinical stage (CS) I non-seminomatous germ cell tumours (NSGCTs) of the testis in the setting of a phase III trial. We report the recurrences and late toxicities of this study after 13 years of follow-up. Methods: Questionnaires from 382 patients with CS I NSGCT treated with 1 cycle of adjuvant BEP (arm A) or RPLND thorn two cycles of adjuvant BEP in cases of pathological stage II disease (arm B) were evaluated regarding recurrences and late toxicity. Overall, information on recurrence status was available in 337 patients, and 170 questionnaires were evaluable for toxicity (arm A: 95; arm B: 75). Results: With a median follow-up of 13.8 years (0-22), 3 patients (1.6%) in arm A and 16 patients (8.4%) in arm B experienced recurrence. The 15-year PFS in arm A/B was 99% (CI 96-100%)/92% (CI 89-99%) (p = 0.0049). The 15-year OS in arm A/B was 93% (CI 87-97%)/ 93% (CI 86-97%) (p = 0.83). Eight patients (4.2%) in arm A and four patients (2.1%) in arm B showed metachronous secondary testicular cancer (p = 0.26). Five patients (2.6%) in arm A and four patients (2.1%) in arm B developed other malignancies. Toxicities were not significantly different apart from retrograde ejaculation, which occurred more frequently after RPLND (10% versus 24%, p = 0.01). Conclusions: With long-term observation, one cycle of BEP remains superior to RPLND in preventing recurrence and was tolerated without any clinically relevant long-term toxicities. 2021 Elsevier Ltd. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Hiester, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Fingerhut, Anna UNSPECIFIED UNSPECIFIED UNSPECIFIED Niegisch, Gunter UNSPECIFIED UNSPECIFIED UNSPECIFIED Siener, Roswitha UNSPECIFIED UNSPECIFIED UNSPECIFIED Krege, Susanne UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmelz, Hans-Ulrich UNSPECIFIED UNSPECIFIED UNSPECIFIED Dieckmann, Klaus-Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Heidenreich, Axel UNSPECIFIED UNSPECIFIED UNSPECIFIED Kwasny, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Pechoel, Maik UNSPECIFIED UNSPECIFIED UNSPECIFIED Lehmann, Jan UNSPECIFIED UNSPECIFIED UNSPECIFIED Kliesch, Sabine UNSPECIFIED UNSPECIFIED UNSPECIFIED Koehrmann, Kai-Uwe UNSPECIFIED UNSPECIFIED UNSPECIFIED Fimmers, Rolf UNSPECIFIED UNSPECIFIED UNSPECIFIED Loy, Volker UNSPECIFIED UNSPECIFIED UNSPECIFIED Wittekind, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Hartmann, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Albers, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-599930
DOI:	10.1016/j.ejca.2021.06.022
Journal or Publication Title:	Eur. J. Cancer
Volume:	155
Page Range:	S. 64 - 73
Date:	2021
Publisher:	ELSEVIER SCI LTD
Place of Publication:	OXFORD
ISSN:	1879-0852
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language TESTICULAR CANCER; LONG-TERM; CHEMOTHERAPY; RISK; SURVEILLANCE Multiple languages Oncology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/59993