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Lookup NU author(s): Dr Christoph OingORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© 2021, The Author(s). 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.
Author(s): Heinzelbecker J, Schmidt S, Lackner J, Busch J, Bokemeyer C, Classen J, Dieing A, Hakenberg O, Krege S, Papachristofilou A, Pfister D, Ruf C, Schmelz H, Schmidberger H, Souchon R, Winter C, Zengerling F, Kliesch S, Albers P, Oing C
Publication type: Article
Publication status: Published
Journal: World Journal of Urology
Year: 2022
Volume: 40
Issue: 12
Pages: 2829-2841
Print publication date: 01/12/2022
Online publication date: 15/11/2021
Acceptance date: 25/10/2021
Date deposited: 26/07/2024
ISSN (print): 0724-4983
ISSN (electronic): 1433-8726
Publisher: Springer Science and Business Media Deutschland GmbH
URL: https://doi.org/10.1007/s00345-021-03873-5
DOI: 10.1007/s00345-021-03873-5
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