Top

World Journal of Urology

Published in:

01-02-2022 | Seminoma | Topic Paper

Clinical stage II seminoma: management options

Authors: Muhannad Alsyouf, Siamak Daneshmand

Published in: World Journal of Urology | Issue 2/2022

Abstract

Introduction

The management of clinical stage II seminoma has evolved with a recent emphasis on minimizing long-term morbidity while achieving oncologic cure.

Methods

In this review we discuss the available management options for clinical stage II seminoma with an emphasis on the emerging role of surgery in this patient population.

Results

Historically, treatment options available to clinical stage II seminoma patients were limited to radiotherapy and chemotherapy. Survival rates with these options are excellent; however, both are associated with significant long-term morbidities including cardiovascular, pulmonary, and neurologic toxicities. Additionally, higher rates of secondary malignancies are witnessed in this young patient population, decades after successful treatment of the primary cancer. Recently, retroperitoneal lymph node dissection has been proposed as a first-line treatment option for patients with low-volume metastatic seminoma.

Conclusion

The SEMS and PRIMETEST trials are two studies examining the role of primary retroperitoneal lymph node dissection in clinical stage II seminoma, and early data show significant promise.

Domont J et al (2013) A risk-adapted strategy of radiotherapy or cisplatin-based chemotherapy in stage II seminoma. Urol Oncol 31(5):697–705CrossRef

Stephenson A et al (2019) Diagnosis and treatment of early stage testicular cancer: AUA guideline. J Urol 202(2):272–281CrossRef

Chung PW et al (2004) Stage II testicular seminoma: patterns of recurrence and outcome of treatment. Eur Urol 45(6):754–759 (discussion 759–760)CrossRef

Garcia-del-Muro X et al (2008) Chemotherapy as an alternative to radiotherapy in the treatment of stage IIA and IIB testicular seminoma: a Spanish germ cell cancer group study. J Clin Oncol 26(33):5416–5421CrossRef

Haugnes HS, Oldenburg J, Bremnes RM (2015) Pulmonary and cardiovascular toxicity in long-term testicular cancer survivors. Urol Oncol 33(9):399–406CrossRef

Hu B, Daneshmand S (2018) Retroperitoneal lymph node dissection as primary treatment for metastatic seminoma. Adv Urol 2018:7978958CrossRef

Giannatempo P et al (2015) Radiotherapy or chemotherapy for clinical stage IIA and IIB seminoma: a systematic review and meta-analysis of patient outcomes. Ann Oncol 26(4):657–668CrossRef

Zagars GK, Pollack A (2001) Radiotherapy for stage II testicular seminoma. Int J Radiat Oncol Biol Phys 51(3):643–649CrossRef

Chung PW et al (2003) Appropriate radiation volume for stage IIA/B testicular seminoma. Int J Radiat Oncol Biol Phys 56(3):746–748CrossRef

10.

Classen J et al (2003) Radiotherapy for stages IIA/B testicular seminoma: final report of a prospective multicenter clinical trial. J Clin Oncol 21(6):1101–1106CrossRef

11.

Hallemeier CL et al (2013) Long-term outcomes of radiotherapy for stage II testicular seminoma–the Mayo clinic experience. Urol Oncol 31(8):1832–1838CrossRef

12.

van Leeuwen FE et al (1993) Second cancer risk following testicular cancer: a follow-up study of 1909 patients. J Clin Oncol 11(3):415–424CrossRef

13.

Beyer J et al (2013) Maintaining success, reducing treatment burden, focusing on survivorship: highlights from the third European consensus conference on diagnosis and treatment of germ-cell cancer. Ann Oncol 24(4):878–888CrossRef

14.

Tandstad T et al (2011) Management of seminomatous testicular cancer: a binational prospective population-based study from the Swedish norwegian testicular cancer study group. J Clin Oncol 29(6):719–725CrossRef

15.

Haugnes HS et al (2010) Cardiovascular risk factors and morbidity in long-term survivors of testicular cancer: a 20 year follow-up study. J Clin Oncol 28(30):4649–4657CrossRef

16.

Brydoy M et al (2005) Paternity following treatment for testicular cancer. J Natl Cancer Inst 97(21):1580–1588CrossRef

17.

Pont J, Albrecht W (1997) Fertility after chemotherapy for testicular germ cell cancer. Fertil Steril 68(1):1–5CrossRef

18.

Travis LB et al (2005) Second cancers among 40,576 testicular cancer patients: focus on long-term survivors. J Natl Cancer Inst 97(18):1354–1365CrossRef

19.

Hellesnes R et al. (2021) Testicular cancer in the cisplatin era: causes of death and mortality rates in a population-based cohort. J Clin Oncol. https://doi.org/10.1200/JCO.21.00637CrossRefPubMed

20.

Stephenson AJ et al (2007) Nonrandomized comparison of primary chemotherapy and retroperitoneal lymph node dissection for clinical stage IIA and IIB nonseminomatous germ cell testicular cancer. J Clin Oncol 25(35):5597–5602CrossRef

21.

Weissbach L et al (2000) RPLND or primary chemotherapy in clinical stage IIA/B nonseminomatous germ cell tumors? Results of a prospective multicenter trial including quality of life assessment. Eur Urol 37(5):582–594CrossRef

22.

Syan-Bhanvadia S et al (2017) Midline extraperitoneal approach to retroperitoneal lymph node dissection in testicular cancer: minimizing surgical morbidity. Eur Urol 72(5):814–820CrossRef

23.

Warszawski N, Schmucking M (1997) Relapses in early-stage testicular seminoma: radiation therapy versus retroperitoneal lymphadenectomy. Scand J Urol Nephrol 31(4):355–359CrossRef

24.

Mezvrishvili Z, Managadze L (2006) Retroperitoneal lymph node dissection for high-risk stage I and stage IIA seminoma. Int Urol Nephrol 38(3–4):615–619PubMed

25.

Hu B et al (2015) Retroperitoneal lymph node dissection as first-line treatment of node-positive seminoma. Clin Genitourin Cancer 13(4):e265–e269CrossRef

26.

Daneshmand S et al (2021) SEMS trial: result of a prospective, multi-institutional phase II clinical trial of surgery in early metastatic seminoma treatment. J Clin Oncol 39(6_suppl):375–375CrossRef

27.

Albers P et al (2019) The PRIMETEST trial: interim analysis of a phase II trial for primary retroperitoneal lymph node dissection (RPLND) in stage II A/B seminoma patients without adjuvant treatment. J Clin Oncol 37(7_Suppl):507–507CrossRef

28.

Nicol D et al (2020) MP11-05 outcomes with minimally invasive retroperitoneal lymph node dissection (MI-RPLND) and single dose carboplatin in clinical stage 2 seminoma. J Urol 203(4):136–137CrossRef

Title: Clinical stage II seminoma: management options
Authors: Muhannad Alsyouf
Siamak Daneshmand
Publication date: 01-02-2022
Publisher: Springer Berlin Heidelberg
Keywords: Seminoma
Seminoma
Systemic Therapy
Radiotherapy
Cytostatic Therapy
Published in: World Journal of Urology / Issue 2/2022
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-021-03854-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Clinical stage II seminoma: management options

Abstract

Introduction

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 2/2022

Proteomic profiling of cisplatin-resistant and cisplatin-sensitive germ cell tumour cell lines using quantitative mass spectrometry

The development and application of a triage system for urolithiasis during COVID-19

Comment on: Thulium laser transurethral vaporesection versus transurethral resection of the prostate for benign prostatic obstruction: the UNBLOCS RCT

Acute kidney injury and percutaneous nephrolithotomy: incidence and predictive factors

Experimental ex-vivo performance study comparing a novel, pulsed thulium solid-state laser, chopped thulium fibre laser, low and high-power holmium:YAG laser for endoscopic enucleation of the prostate

Clinical characteristics, treatment patterns and relapse in patients with clinical stage IS testicular cancer