Universität zu Köln

Ruf, Christian G., Schmidt, Stefanie, Kliesch, Sabine, Oing, Christoph, Pfister, David, Busch, Jonas, Heinzelbecker, Julia ORCID: 0000-0001-8993-7171, Winter, Christian, Zengerling, Friedemann, Albers, Peter, Oechsle, Karin, Krege, Susanne, Lackner, Julia and Dieckmann, Klaus-Peter (2022). Testicular germ cell tumours' clinical stage I: comparison of surveillance with adjuvant treatment strategies regarding recurrence rates and overall survival-a systematic review. World J. Urol., 40 (12). S. 2889 - 2901. NEW YORK: SPRINGER. ISSN 1433-8726

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Abstract

Purpose Testicular germ cell tumours (GCTs) represent the most common malignancy in young adult males with two thirds of all cases presenting with clinical stage I (CSI). Active surveillance is the management modality mostly favoured by current guidelines. This systematic review assesses the treatment results in CSI patients concerning recurrence rate and overall survival in non-seminoma (NS) and pure seminoma (SE) resulting from surveillance in comparison to adjuvant strategies. Methods/systematic review We performed a systematic literature review confining the search to most recent studies published 2010-2021 that reported direct comparisons of surveillance to adjuvant management. We searched Medline and the Cochrane Library with additional hand-searching of reference lists to identify relevant studies. Data extraction and quality assessment of included studies were performed with stratification for histology (NS vs. SE) and treatment modalities. The results were tabulated and evaluated with descriptive statistical methods. Results Thirty-four studies met the inclusion criteria. In NS patients relapse rates were 12 to 37%, 0 to 10%, and 0 to 11.8% for surveillance, chemotherapy and for retroperitoneal lymph node dissection (RPLND) while overall survival rates were 90.7-100%, 91.7-100%, and 97-99.1%, respectively. In SE CSI, relapse rates were 0-22.3%, 0-5%, and 0-12.5% for surveillance, radiotherapy, chemotherapy, while overall survival rates were 84.1-98.7%, 83.5-100%, and 92.3-100%, respectively. Conclusion In both histologic subgroups, active surveillance offers almost identical overall survival as adjuvant management strategies, however, at the expense of higher relapse rates. Each of the management strategies in CSI GCT patients have specific merits and shared-decision-making is advised to tailor treatment.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Ruf, Christian G. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmidt, Stefanie UNSPECIFIED UNSPECIFIED UNSPECIFIED Kliesch, Sabine UNSPECIFIED UNSPECIFIED UNSPECIFIED Oing, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfister, David UNSPECIFIED UNSPECIFIED UNSPECIFIED Busch, Jonas UNSPECIFIED UNSPECIFIED UNSPECIFIED Heinzelbecker, Julia UNSPECIFIED orcid.org/0000-0001-8993-7171 UNSPECIFIED Winter, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Zengerling, Friedemann UNSPECIFIED UNSPECIFIED UNSPECIFIED Albers, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Oechsle, Karin UNSPECIFIED UNSPECIFIED UNSPECIFIED Krege, Susanne UNSPECIFIED UNSPECIFIED UNSPECIFIED Lackner, Julia UNSPECIFIED UNSPECIFIED UNSPECIFIED Dieckmann, Klaus-Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-692448
DOI:	10.1007/s00345-022-04145-6
Journal or Publication Title:	World J. Urol.
Volume:	40
Number:	12
Page Range:	S. 2889 - 2901
Date:	2022
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1433-8726
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language RISK-ADAPTED TREATMENT; LYMPH-NODE DISSECTION; TERM-FOLLOW-UP; SEMINOMA PATIENTS; PROGNOSTIC-FACTORS; CANCER; RELAPSE; MANAGEMENT; CARBOPLATIN; OUTCOMES Multiple languages Urology & Nephrology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/69244