Recommendations for followup of stage I and II seminoma: The Princess Margaret Cancer Centre approach

Lieng, Hester; Warde, Padraig; Bedard, Philippe L.; Hamilton, R.; Hansen, Aaron R.; Mas, Jewett; O’Malley, Martin; Sweet, Joan; Chung, Peter

doi:10.5489/cuaj.4531

Cited by 18 publications

(32 citation statements)

References 77 publications

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“…However surveillance requires excellent compliance with frequent clinical reviews and investigations for up to 10 years 8 . Radiation from CT scanning increases the SMN risk by 1 in 1000 per 10mSV, with each abdominopelvic CT scan equivalent to 10 to 20mSV 4,8,15 . Non‐compliance with surveillance was only 4.7% in a large Danish study; however, patients who default surveillance may compromise their chances of cure 12 .…”

Section: Discussionmentioning

confidence: 99%

“…New Zealand Ministry of Health data from 2005 to 2017 show that Maori men have consistently higher rates of testicular cancer than non‐Maori men 3 . About 80% of seminoma present with clinical stage 1 (CS1) disease, with an estimated relapse rate of 13% to 20% without adjuvant treatment 1,4,5 . However, the high curability at relapse has led to ongoing debate about whether optimal postoperative management is adjuvant treatment or surveillance 1,4,6 …”

Section: Introductionmentioning

confidence: 99%

“…Surveillance avoids treatment in the majority of patients and has largely become the preferred strategy 4,8,12 . However, relapsed patients are exposed to the far greater toxicity of cisplatin‐based chemotherapy 7,13,14 .…”

Section: Introductionmentioning

confidence: 99%

“…There is no consensus on duration of surveillance, which can be up to 10 years, requiring up to 10 abdominal CT scans. This exposes patients to significant doses of radiation, raising concerns of long‐term SMN risk 4,8,15 . From a psychological perspective, it is well known that patients with testicular cancer experience fear of relapse; however, it is unclear whether this is increased by surveillance 16,17 …”

Section: Introductionmentioning

confidence: 99%

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Two cycles of adjuvant carboplatin for clinical stage 1 testicular seminoma in New Zealand centres: A retrospective analysis of efficacy and long‐term events

et al. 2020

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Background Adjuvant carboplatin reduces relapse risk in clinical stage 1 (CS1) seminoma, though there is a paucity of long‐term safety data. Aim Our objective was to report long‐term outcomes of two cycles of adjuvant carboplatin dosed at area under the time–concentration curve (AUC) of 7. Methods and results We performed a retrospective analysis on treatment and outcomes of patients with CS1 seminoma who received adjuvant carboplatin from 2000 to 2016 at our centres in the Midland Region, New Zealand. Of 159 patients, median age 39 years, 153 received two cycles of carboplatin: 147 dosed at AUC7 and 6 at AUC6. Six patients had one cycle of carboplatin AUC7. One patient relapsed at 22 months and died of bleomycin pneumonitis 2 months after achieving a complete response with BEP chemotherapy. Neither RTI (present in 21.3%) nor tumor size >4 cm (in 43.3%) was predictive of relapse. Median follow‐up was 106 months. At 15 years, outcomes were: relapse‐free survival 99.4%, overall survival 91.4%, disease‐specific survival 100%, subsequent malignant neoplasm rate 7.6%, and second testicular germ cell tumor rate 3.85%. One patient had persistent grade 1 thrombocytopenia at 46 months. Conclusions These data add to the body of evidence that two cycles of carboplatin AUC7 is safe and effective adjuvant treatment for CS1 seminoma.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Two cycles of adjuvant carboplatin for clinical stage 1 testicular seminoma in New Zealand centres: A retrospective analysis of efficacy and long‐term events

et al. 2020

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“…The evaluation of serum hormone levels (total testosterone, luteinizing hormone and follicle-stimulating hormone) is also included in some of the S protocols. Further refinements of the protocols will likely minimize chest imaging, especially in patients with CSI without abdominal or serologic relapse [43,44]. Based on the decades of experience and ubiquity of this imaging modality, the CT scan of the abdomen was used to survey the TC patients.…”

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confidence: 99%

Stage I testicular seminoma risk-adapted therapeutic management

Mrinakova

Kajo

Lehotská

et al. 2021

neo

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Following orchiectomy, patients with clinical stage I (CSI) testicular seminoma may be managed by active surveillance (S) or adjuvant treatment (radiotherapy or chemotherapy). In view of the published data on long-term toxicity, especially second malignant neoplasms (SMNs), adjuvant radiotherapy (ART) is currently no longer recommended as an adjuvant therapy option for these patients. The purpose of our recent study was to compare the impact of two selected treatment approaches-S versus adjuvant chemotherapy (ACT) on the survival of patients with CSI testicular seminoma. This cross-sectional study analyzed a total of 139 patients collected at a single center between 10/2011-5/2020, with CSI testicular seminoma, stratified into two groups according to risk-adapted therapeutic approaches. In the S group (low-risk-without rete testis invasion-RTI, primary tumor size < 4 cm), consisting of 77 patients, who underwent S, relapse occurred in 10 (13.0%) patients after a mean follow-up of 14.3 months. In the ACT group (high-risk-RTI and/or primary tumor size > 4 cm), consisting of 62 patients, who were treated with ACT, relapse occurred in 5 (8.1%) patients after a mean follow-up of 11.6 months. Overall survival of patients in both groups was 100% with a mean follow-up of 43.9 months. A statistically significant difference in progression-free survival (PFS) between these two groups was not found. Based on our findings, ACT seems to be an adequate treatment for patients with a high-risk of relapse, as well as S for those with a low-risk of relapse. Despite its excellent prognosis, optimal management of CSI testicular seminoma remains controversial, with variations in expert opinion and international guidelines.

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Young adult Latino testicular cancer survivors: a pilot study of Goal-focused Emotion regulation Therapy (GET)

Hoyt,

Campos,

Lechuga

et al. 2024

Support Care Cancer

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Purpose Young adult Latino testicular cancer survivors experience adverse impacts after treatment. We developed Goal-focused Emotion regulation Therapy (GET) to improve distress symptoms, goal navigation skills, and emotion regulation. This open pilot trial extended GET to Latino young adult survivors of testicular cancer and assessed feasibility and tolerability as well as changes in anxiety and depressive symptoms. Secondary outcomes included goal navigation, emotion regulation, and components of hope-related goal processes (i.e., agency and pathway mapping). To assess the extent to which GET is culturally congruent or in need of adaptation, the influence of simpatía and acculturative stress were also examined. Methods Thirty-five eligible young adult (age 18–39) survivors treated with chemotherapy were enrolled and assessed at baseline. Study acceptability, tolerability, and therapeutic alliance were examined. Preliminary efficacy was evaluated for changes in anxiety and depressive symptoms as well as psychological processes (goal navigation, agency, goal pathway skill, and emotion regulation) from baseline to immediate post- and 3-month post-intervention. Results Among the 35 men assessed at baseline, 54% initiated intervention sessions. Among these, 94.7% completed all study procedures. Helpfulness ratings of intervention components and therapeutic alliance scores were strong. Repeated measures ANOVA revealed significant reductions in anxiety and depressive symptoms from pre- to post-intervention with sustained change at the 3-month follow-up. Favorable patterns of change were also observed in GET-related psychological processes. Simpatía was associated with less depressive symptoms at post-intervention, but not change in anxiety. Acculturative stress was associated with increased anxiety and depressive symptoms over time. Conclusion GET is a feasible and acceptable intervention for reducing adverse outcomes after testicular cancer for young adult Latino men. Results should be considered preliminary but suggest meaningful changes in emotional and psychological outcomes.

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Recommendations for followup of stage I and II seminoma: The Princess Margaret Cancer Centre approach

Cited by 18 publications

References 77 publications

Two cycles of adjuvant carboplatin for clinical stage 1 testicular seminoma in New Zealand centres: A retrospective analysis of efficacy and long‐term events

Two cycles of adjuvant carboplatin for clinical stage 1 testicular seminoma in New Zealand centres: A retrospective analysis of efficacy and long‐term events

Stage I testicular seminoma risk-adapted therapeutic management

Young adult Latino testicular cancer survivors: a pilot study of Goal-focused Emotion regulation Therapy (GET)

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