https://doi.org/10.4081/aiua.2023.11513

Surveillance as a safe and effective option for treatment of stage I seminoma

Vol. 95 No. 3 (2023)
Submitted: June 8, 2023
Accepted: July 14, 2023
Published: September 5, 2023
Seminoma, Surveillance, Radiotherapy, Adjuvant chemotherapy, recurrence
Abstract Views: 515
PDF: 271
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Authors

Vasco Quaresma
vpdquaresma@gmail.com
https://orcid.org/0000-0001-9225-1437
Urology Department, Centro Hospitalar e Universitário de Coimbra; Faculty of Medicine of the University of Coimbra, Portugal.
Diogo Henriques
https://orcid.org/0000-0002-7033-6891
Faculty of Medicine of the University of Coimbra, Portugal.
Lorenzo Marconi
Urology Department, Centro Hospitalar e Universitário de Coimbra; Faculty of Medicine of the University of Coimbra, Portugal.
João Lorigo
Urology Department, Centro Hospitalar e Universitário de Coimbra, Portugal.
Ana-Marta Ferreira
Urology Department, Centro Hospitalar e Universitário de Coimbra, Portugal.
Roberto Jarimba
Urology Department, Centro Hospitalar e Universitário de Coimbra; Faculty of Medicine of the University of Coimbra, Portugal.
Pedro Nunes
Urology Department, Centro Hospitalar e Universitário de Coimbra; Faculty of Medicine of the University of Coimbra, Portugal.
Arnaldo Figueiredo
https://orcid.org/0000-0002-7157-0081
Urology Department, Centro Hospitalar e Universitário de Coimbra; Faculty of Medicine of the University of Coimbra, Portugal.
Belmiro Parada
Urology Department, Centro Hospitalar e Universitário de Coimbra; Faculty of Medicine of the University of Coimbra, Portugal.

Introdubction: Stage I seminoma has a very good prognosis, yet approximately 15% have subclinical metastatic disease and will relapse after orchidectomy alone. Several management approaches have been investigated. We aimed to evaluate the clinical outcomes of real-world patients with stage I seminoma, analysing prognostic factors influencing treatment choice and oncological outcomes. Methods: Retrospective, single institution study, with 55 patients diagnosed with clinical stage I seminoma between 2007 and 2020. Selected patients were analysed regarding three management approaches - surveillance, adjuvant radiotherapy and adjuvant carboplatin AUC7. Overall survival and progression-free survival outcomes were analysed. Predictors of treatment choice were determined, and predictors of recurrence were analysed in patients on active surveillance. Results: The median follow-up time was 91 months (13-165). Overall survival at 10 years was 98.2%. Stage I seminoma patients had a 1-, 3- and 10-year progression free survival of 98%, 94% and 89%, respectively. Three-year progression free survival was 92.0% for those on active surveillance (IC95%, 91.5-92.5%), 95.2% for carboplatin (IC95%, 94.8-95.6%) and 100% for those on adjuvant radiotherapy (p > 0.05). All relapses on active surveillance protocols occurred during the first 24 months. Overall, 43% of patients who underwent adjuvant treatment reported adverse effects of therapy, with higher incidence on radiotherapy group (63%). Conclusions: Stage I seminoma have excellent prognosis, high cure rates, and low treatment-associated morbidity. Active surveillance is a safe modality when applied to selected patients. Adjuvant radiotherapy and adjuvant chemotherapy with carboplatin show similar results, with fewer adverse effects on chemotherapy arm.

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How to Cite

Quaresma, V., Henriques, D., Marconi, L., Lorigo, J., Ferreira, A.-M., Jarimba, R., Nunes, P., Figueiredo, A., & Parada, B. (2023). Surveillance as a safe and effective option for treatment of stage I seminoma. Archivio Italiano Di Urologia E Andrologia, 95(3). https://doi.org/10.4081/aiua.2023.11513
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