Outcome of men with relapse after adjuvant carboplatin for clinical stage i seminoma

Research output: Contribution to journalArticle

Abstract

Purpose Adjuvant carboplatin is one of three management strategies that may follow inguinal orchiectomy in clinical stage I seminoma. However, little is known about the outcome of patients who experience a relapse after such treatment. Patients and Methods Data from 185 patients who relapsed after adjuvant carboplatin between January 1987 and August 2013 at 31 centers/groups from 20 countries were collected and retrospectively analyzed. Primary outcomes were disease-free survival and overall survival. Secondary outcomes were time to, stage at, and treatment of relapse as well as rate of subsequent relapses. Results With a median follow-up of 53 months (95% CI, 48 to 60 months) the 5-year disease-free survival was 82% (95% CI, 77% to 89%), and the 5-year overall survival was 98% (95% CI, 95% to 100%). The median time from orchiectomy to relapse was 19 months (95% CI, 17 to 23 months); 15% (95% CI, 10% to 21%) of relapses occurred > 3 years after treatment. The majority of relapses were detected by computed tomography scan during routine follow-up, 98% in the International Germ Cell Cancer Collaborative Group good prognosis group. Chemotherapy was administered to 92% of patients, mostly as standard first-line treatment corresponding to stage; 8% of patients had additional local treatments. Only 28 patients experienced a second relapse. At last follow-up, 174 (94%) of 185 patients were alive without disease, and four patients with disease. Seven patients died, three of whom due to progressive disease. Conclusion Within the limitations of a retrospective analysis, the results suggest that the majority of patients who experience a relapse after adjuvant carboplatin for clinical stage I seminoma can be successfully treated with a cisplatin-based chemotherapy regimen adequate for stage. Because 15% of the relapses occurred > 3 years after adjuvant treatment, a minimum of 5 years follow-up is recommended.

Details

Authors
  • Stefanie Fischer
  • Torgrim Tandstad
  • Matthew Wheater
  • Emilio Porfiri
  • Aude Fléchon
  • Jorge Aparicio
  • Dirk Klingbiel
  • Breda Skrbinc
  • Umberto Basso
  • Jonathan Shamash
  • Anja Lorch
  • Klaus-Peter Dieckmann
  • Gabriella Cohn-Cedermark
  • Olof Ståhl
  • Caroline Chau
  • Edurne Arriola
  • Kalena Marti
  • Paul Hutton
  • Brigitte Laguerre
  • Pablo Maroto
  • And 2 others
  • Jörg Beyer
  • Silke Gillessen
Organisations
External organisations
  • Kantonsspital St Gallen
  • St. Olav’s University Hospital
  • University Hospital Southampton
  • University Hospitals Birmingham
  • Centre Léon Bérard
  • University and Polytechnic Hospital la Fe
  • SAKK Coordinating Center
  • Institute of Oncology, Ljubljana
  • Veneto Institute of Oncology
  • St Bartholomew's Hospital
  • Universitätsklinikum Düsseldorf
  • Klinik für Urologie
  • Karolinska Institutet
  • Karolinska University Hospital
  • Skåne University Hospital
  • Centre Eugène Marquis
  • Hospital de Sant Pau
  • University Hospital of Zurich
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Cancer and Oncology
Original languageEnglish
Pages (from-to)194-200
Number of pages7
JournalJournal of Clinical Oncology
Volume35
Issue number2
Publication statusPublished - 2017 Jan 10
Publication categoryResearch
Peer-reviewedYes