Active surveillance as a successful management strategy for patients with clinical stage I germ cell testicular cancer
| Autor: | R Escudero-Ávila, I Osman, M Japón-Rodríguez, P Sancho, Juan Manuel Praena-Fernández, B Vargas, Rafael Medina, B Perez-Valderrama, F Fernandez, J D Rodríguez-Castaño, Ignacio Duran |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male 0301 basic medicine Oncology Cancer Research medicine.medical_specialty Adolescent medicine.medical_treatment Population Testicular Neoplasm Disease Multimodal Imaging Young Adult 03 medical and health sciences 0302 clinical medicine Testicular Neoplasms Internal medicine Humans Medicine Longitudinal Studies Stage (cooking) Watchful Waiting education Testicular cancer Aged Retrospective Studies education.field_of_study Chemotherapy business.industry Disease Management General Medicine Seminoma Middle Aged Neoplasms Germ Cell and Embryonal Prognosis medicine.disease Survival Rate Radiation therapy 030104 developmental biology Population Surveillance 030220 oncology & carcinogenesis business Orchiectomy Follow-Up Studies |
| Zdroj: | Clinical and Translational Oncology. 21:796-804 |
| ISSN: | 1699-3055 1699-048X |
| DOI: | 10.1007/s12094-018-1990-5 |
| Popis: | Cancer-specific survival for patients with clinical stage I (CSI) germ cell testicular cancer (GCTC) is outstanding after inguinal orchidectomy regardless the treatment utilized. This study evaluated whether active surveillance (AS) of such patients yielded similar health outcomes to other therapeutic strategies such as adjuvant chemotherapy, radiotherapy or primary retroperitoneal lymphadenectomy as described in the literature. Patients with CSI GCTC were screened between January 2012 and December 2016. Patients had previously undergone inguinal orchidectomy as the primary treatment and chosen AS as their preferred management strategy after receiving information about all available strategies. Out of 91 patients screened, 82 patients selected AS as their preferred management strategy. Relapse rate in the overall population was 20% (95% CI 12–30) and median time to relapse was 11.5 months (range 1.0–35.0). In patients with seminomatous tumors, relapse rate decreased to 13% and median time to relapse was 13 months; whereas in patients with non-seminomatous tumors, relapse rate was 33% (IA) or 29% (IB) and median time to relapse was 12 months in stage IA and 4.5 months in stage IB patients. All relapses were rescued with three or four cycles of chemotherapy and two also required a retroperitoneal lymphadenectomy. All patients are currently alive and free of disease. The clinical outcomes of patients with CSI GCTC managed by AS in this series were excellent. This strategy limited the administration of active treatments specifically to the minority of patients who relapsed without compromising performance. |
| Databáze: | OpenAIRE |
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