Therapy of clinical stage IIA and IIB seminoma : a systematic review
© 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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:40 |
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| Enthalten in: |
World journal of urology - 40(2022), 12 vom: 26. Dez., Seite 2829-2841 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Heinzelbecker, Julia [VerfasserIn] |
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| Links: |
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| Themen: |
CS IIA/B |
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| Anmerkungen: |
Date Completed 02.12.2022 Date Revised 28.12.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s00345-021-03873-5 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM333176383 |
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| 100 | 1 | |a Heinzelbecker, Julia |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Therapy of clinical stage IIA and IIB seminoma |b a systematic review |
| 264 | 1 | |c 2022 | |
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| 500 | |a Date Completed 02.12.2022 | ||
| 500 | |a Date Revised 28.12.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2021. The Author(s). | ||
| 520 | |a PURPOSE: The optimal treatment for clinical stage (CS) IIA/IIB seminomas is still controversial. We evaluated current treatment options | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Systematic Review | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a CS IIA/B | |
| 650 | 4 | |a Seminoma | |
| 650 | 4 | |a Systematic review | |
| 650 | 4 | |a Testicular cancer | |
| 650 | 4 | |a Toxicity | |
| 650 | 4 | |a Treatment | |
| 700 | 1 | |a Schmidt, Stefanie |e verfasserin |4 aut | |
| 700 | 1 | |a Lackner, Julia |e verfasserin |4 aut | |
| 700 | 1 | |a Busch, Jonas |e verfasserin |4 aut | |
| 700 | 1 | |a Bokemeyer, Carsten |e verfasserin |4 aut | |
| 700 | 1 | |a Classen, Johannes |e verfasserin |4 aut | |
| 700 | 1 | |a Dieing, Annette |e verfasserin |4 aut | |
| 700 | 1 | |a Hakenberg, Oliver |e verfasserin |4 aut | |
| 700 | 1 | |a Krege, Susanne |e verfasserin |4 aut | |
| 700 | 1 | |a Papachristofilou, Alexandros |e verfasserin |4 aut | |
| 700 | 1 | |a Pfister, David |e verfasserin |4 aut | |
| 700 | 1 | |a Ruf, Christian |e verfasserin |4 aut | |
| 700 | 1 | |a Schmelz, Hans |e verfasserin |4 aut | |
| 700 | 1 | |a Schmidberger, Heinz |e verfasserin |4 aut | |
| 700 | 1 | |a Souchon, Rainer |e verfasserin |4 aut | |
| 700 | 1 | |a Winter, Christian |e verfasserin |4 aut | |
| 700 | 1 | |a Zengerling, Friedemann |e verfasserin |4 aut | |
| 700 | 1 | |a Kliesch, Sabine |e verfasserin |4 aut | |
| 700 | 1 | |a Albers, Peter |e verfasserin |4 aut | |
| 700 | 1 | |a Oing, Christoph |e verfasserin |4 aut | |
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