Heinzelbecker, Julia, Schmidt, Stefanie, Lackner, Julia, Busch, Jonas, Bokemeyer, Carsten, Classen, Johannes, Dieing, Annette, Hakenberg, Oliver, Krege, Susanne, Papachristofilou, Alexandros, Pfister, David, Ruf, Christian, Schmelz, Hans, Schmidberger, Heinz, Souchon, Rainer, Winter, Christian, Zengerling, Friedemann, Kliesch, Sabine, Albers, Peter and Oing, Christoph . Therapy of clinical stage IIA and IIB seminoma: a systematic review. World J. Urol.. NEW YORK: SPRINGER. ISSN 1433-8726

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Abstract

Purpose The optimal treatment for clinical stage (CS) IIA/IIB seminomas is still controversial. We evaluated current treatment options. Methods A systematic review was performed. Only randomized clinical trials and comparative studies published from January 2010 until February 2021 were included. Search items included: seminoma, CS IIA, CS IIB and therapy. Outcome parameters were relapse rate (RR), relapse-free (RFS), overall and cancer-specific survival (OS, CSS). Additionally, acute and long-term side effects including secondary malignancies (SMs) were analyzed. Results Seven comparative studies (one prospective and six retrospective) were identified with a total of 5049 patients (CS IIA: 2840, CS IIB: 2209). The applied treatment modalities were radiotherapy (RT) (n = 3049; CS IIA: 1888, CSIIB: 1006, unknown: 155) and chemotherapy (CT) or no RT (n = 2000; CS IIA: 797, CS IIB: 1074, unknown: 129). In CS IIA, RRs ranged from 0% to 4.8% for RT and 0% for CT. Concerning CS IIB RRs of 9.5%-21.1% for RT and of 0%-14.2% for CT have been reported. 5-year OS ranged from 90 to 100%. Only two studies reported on treatment-related toxicities. Conclusions RT and CT are the most commonly applied treatments in CS IIA/B seminoma. In CS IIA seminomas, RRs after RT and CT are similar. However, in CS IIB, CT seems to be more effective. Survival rates of CS IIA/B seminomas are excellent. Consequently, long-term toxicities and SMs are important survivorship issues. Alternative treatment approaches, e.g., retroperitoneal lymph node dissection (RPLND) or dose-reduced sequential CT/RT are currently under prospective investigation.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Heinzelbecker, JuliaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schmidt, StefanieUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lackner, JuliaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Busch, JonasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bokemeyer, CarstenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Classen, JohannesUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dieing, AnnetteUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hakenberg, OliverUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Krege, SusanneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Papachristofilou, AlexandrosUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pfister, DavidUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ruf, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schmelz, HansUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schmidberger, HeinzUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Souchon, RainerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Winter, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Zengerling, FriedemannUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kliesch, SabineUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Albers, PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Oing, ChristophUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-603494
DOI: 10.1007/s00345-021-03873-5
Journal or Publication Title: World J. Urol.
Publisher: SPRINGER
Place of Publication: NEW YORK
ISSN: 1433-8726
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
CISPLATIN-BASED CHEMOTHERAPY; LYMPH-NODE DISSECTION; TESTICULAR SEMINOMA; LONG-TERM; RADIATION-THERAPY; RADIOTHERAPY; CANCER; MANAGEMENT; CARBOPLATIN; OUTCOMESMultiple languages
Urology & NephrologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/60349

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