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Open Access 15-11-2021 | Seminoma | Topic Paper

Therapy of clinical stage IIA and IIB seminoma: a systematic review

Authors: Julia Heinzelbecker, Stefanie Schmidt, Julia Lackner, Jonas Busch, Carsten Bokemeyer, Johannes Classen, Annette Dieing, Oliver Hakenberg, Susanne Krege, Alexandros Papachristofilou, David Pfister, Christian Ruf, Hans Schmelz, Heinz Schmidberger, Rainer Souchon, Christian Winter, Friedemann Zengerling, Sabine Kliesch, Peter Albers, Christoph Oing

Published in: World Journal of Urology | Issue 12/2022

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.

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Title: Therapy of clinical stage IIA and IIB seminoma: a systematic review
Authors: Julia Heinzelbecker
Stefanie Schmidt
Julia Lackner
Jonas Busch
Carsten Bokemeyer
Johannes Classen
Annette Dieing
Oliver Hakenberg
Susanne Krege
Alexandros Papachristofilou
David Pfister
Christian Ruf
Hans Schmelz
Heinz Schmidberger
Rainer Souchon
Christian Winter
Friedemann Zengerling
Sabine Kliesch
Peter Albers
Christoph Oing
Publication date: 15-11-2021
Publisher: Springer Berlin Heidelberg
Keywords: Seminoma
Seminoma
Radiotherapy
Cytostatic Therapy
Published in: World Journal of Urology / Issue 12/2022
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-021-03873-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Therapy of clinical stage IIA and IIB seminoma: a systematic review

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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