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Published in:

01-07-2010

Testicular Cancer: When Less is More

Author: Lance C. Pagliaro

Published in: Current Oncology Reports | Issue 4/2010

Abstract

Clinical stage I testicular cancer is highly curable. The treatment options include adjuvant chemotherapy or surveillance for most patients, radiotherapy for seminoma, and retroperitoneal lymph node dissection for selected patients with nonseminomatous germ cell tumors. This review discusses the decision points with emphasis on the advantages and disadvantages of each management option.

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• Albers P, Siener R, Krege S, et al.: Randomized phase III trial comparing retroperitoneal lymph node dissection with one course of bleomycin and etoposide plus cisplatin chemotherapy in the adjuvant treatment of clinical stage I nonseminomatous testicular germ cell tumors: AUO trial AH 01/94 by the German Testicular Cancer Study Group. J Clin Oncol 2008, 26:2966–2972. In this study, patients were randomized 1:1 to receive either RPLND or one course of adjuvant chemotherapy. The recurrence rate was much higher in the RPLND group. The incidence of teratoma in the chemotherapy group was less than 1%. An unexpectedly high rate of retroperitoneal relapses in the RPLND group was attributed to this being a community-based study in which the experience level of the surgeon was variable.CrossRefPubMed

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•• Powles T, Robinson D, Shamash J, et al.: The long-term risks of adjuvant carboplatin treatment for stage I seminoma of the testis. Ann Oncol 2008, 19:443–447. In this study, 199 patients were followed for a median of 9 years after receiving a single injection of carboplatin. Overall mortality, second cancers, and deaths from circulatory disease were similar to that expected for the population. Five patients (4%) developed a second primary testicular cancer, indicating that carboplatin does not decrease this risk.CrossRefPubMed

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Title: Testicular Cancer: When Less is More
Author: Lance C. Pagliaro
Publication date: 01-07-2010
Publisher: Current Science Inc.
Published in: Current Oncology Reports / Issue 4/2010
Print ISSN: 1523-3790
Electronic ISSN: 1534-6269
DOI: https://doi.org/10.1007/s11912-010-0105-4

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