Management options for stage I seminoma

Expert Review of Anticancer Therapy
Jorge Aparicio, Roberto Díaz

Abstract

Stage I seminoma is the most common clinical scenario among patients with testicular cancer. Following orchiectomy, various treatment alternatives (adjuvant radiotherapy, surveillance, chemotherapy) can be offered that yield similar efficacy results and definitive cure is the rule. However, there is no consensus on the optimal management choice and considerable debate has been raised in recent years. The pros and the cons associated with each therapy, as well as their long-term outcomes are discussed in this review. Overall burden of treatment needed, therapy-related morbidity, economic costs, quality of life issues and patient preferences should all be considered. Refinement in the knowledge of predictive factors for relapse and mounting experience with both surveillance and adjuvant chemotherapy have led to consideration of risk-adapted treatment strategies as an alternative to standard radiotherapy. Although this model needs to be improved and validated, active close surveillance for low-risk patients and adjuvant therapy for those uncompliant or at higher risk of relapse seem to be acceptable options for patients with stage I seminoma.

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Citations

Sep 12, 2014·Annals of Oncology : Official Journal of the European Society for Medical Oncology·J AparicioJ R Germà
Feb 10, 2012·Expert Review of Anticancer Therapy·Mausam SingheraAlan Horwich
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Nov 2, 2011·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Jorge AparicioJosé R Germà

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