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Outcomes of surveillance versus adjuvant treatment for patients with stage-I seminoma: a single-center experience.
Akdag, Goncagul; Alan, Ozkan; Dogan, Akif; Yuksel, Zeynep; Yildirim, Sedat; Kinikoglu, Oguzcan; Kudu, Emre; Surmeli, Heves; Odabas, Hatice; Yildirim, Mahmut Emre; Turan, Nedim.
Afiliação
  • Akdag G; Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Cevizli, D-100 Güney Yanyol, Cevizli Mevkii No: 47, Kartal, 34865, Istanbul, Turkey. akdaggoncagul@gmail.com.
  • Alan O; Division of Medical Oncology, School of Medicine, Koç University, Istanbul, Turkey.
  • Dogan A; Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Cevizli, D-100 Güney Yanyol, Cevizli Mevkii No: 47, Kartal, 34865, Istanbul, Turkey.
  • Yuksel Z; Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Cevizli, D-100 Güney Yanyol, Cevizli Mevkii No: 47, Kartal, 34865, Istanbul, Turkey.
  • Yildirim S; Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Cevizli, D-100 Güney Yanyol, Cevizli Mevkii No: 47, Kartal, 34865, Istanbul, Turkey.
  • Kinikoglu O; Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Cevizli, D-100 Güney Yanyol, Cevizli Mevkii No: 47, Kartal, 34865, Istanbul, Turkey.
  • Kudu E; Department of Emergency Medicine, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey.
  • Surmeli H; Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Cevizli, D-100 Güney Yanyol, Cevizli Mevkii No: 47, Kartal, 34865, Istanbul, Turkey.
  • Odabas H; Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Cevizli, D-100 Güney Yanyol, Cevizli Mevkii No: 47, Kartal, 34865, Istanbul, Turkey.
  • Yildirim ME; Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Cevizli, D-100 Güney Yanyol, Cevizli Mevkii No: 47, Kartal, 34865, Istanbul, Turkey.
  • Turan N; Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Cevizli, D-100 Güney Yanyol, Cevizli Mevkii No: 47, Kartal, 34865, Istanbul, Turkey.
World J Urol ; 41(8): 2201-2207, 2023 Aug.
Article em En | MEDLINE | ID: mdl-37351618
INTRODUCTION: Testicular germ cell tumors (seminoma/non-seminoma) are the most common carcinomas in young males, comprising approximately 1% of all carcinomas. In stage-I disease, orchiectomy can cure approximately 85% of patients. Post-surgical options are adjuvant therapy and active surveillance. Our study examined the effects of management options on stage-I seminoma patients followed in our center. METHODS: We evaluated the patients with stage-I testicular seminoma who underwent radical orchiectomy and followed up in the oncology center between 2001 and 2022. The outcomes of management options, survivals were retrospectively analyzed. The prognostic significance of risk factors for relapse on survival was evaluated. RESULTS: Of the 140 patients with stage-I seminoma, 49 (35%) were treated with adjuvant therapy, and 91 (65%) underwent surveillance. The median follow-up duration was 37 months. During the follow-up period, nine patients in the active surveillance group and four in the adjuvant therapy group had a recurrence. There was no statistically significant difference between the two groups (p = 0.67). In the surveillance group, the univariate and multivariate analyzes identified the presence of lymphovascular invasion (p = 0.005, HR: 0.13) as significant prognostic factor for disease-free survival (DFS). In the surveillance cohort, the 5-year DFS rate was 60% for patients with lymphovascular invasion and 93% for those without. There was statistical significance between the two groups (p = 0.003). CONCLUSION: Our study shows that adjuvant therapy does not significantly improve DFS compared to surveillance in patients. In addition, it has been shown that lymphovascular invasion is an important prognostic indicator for DFS in determining the treatment strategy.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias Testiculares / Carcinoma / Seminoma Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Limite: Humans / Male Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias Testiculares / Carcinoma / Seminoma Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Limite: Humans / Male Idioma: En Ano de publicação: 2023 Tipo de documento: Article