Treatment preferences in stage IA and IB testicular seminoma: Multicenter study of anatolian society of medical oncology

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dc.contributor.authorBilici, Ahmet
dc.contributor.authorÖztürk, Türkan
dc.contributor.authorTürkmen, Esma
dc.contributor.authorOdabaş, Hatice
dc.contributor.authorCihan, Şener
dc.contributor.authorSelçukbiricik, Fatih
dc.contributor.authorErdoğan, Bülent
dc.contributor.authorUrakçı, Zuhat
dc.contributor.authorKandemir, Nurten
dc.contributor.authorBayoğu, İbrahim Vedat
dc.contributor.authorDemirci, Umut
dc.contributor.authorOcak Duran, Ayşe
dc.contributor.authorŞendur, Mehmet Ali
dc.contributor.authorYavuzer, Dilek
dc.contributor.authorHarputluoğlu, Hakan
dc.contributor.authorKavgacı, Halil
dc.contributor.authorGümüş, Mahmut
dc.date.accessioned10.07.201910:49:13
dc.date.accessioned2019-07-10T20:04:42Z
dc.date.available10.07.201910:49:13
dc.date.available2019-07-10T20:04:42Z
dc.date.issued2015
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, İç Hastalıkları Ana Bilim Dalı
dc.descriptionWOS: 000361841900031
dc.descriptionPubMed ID: 25605506
dc.description.abstractApproximately 75 % of patients with testicular seminoma present with stage I disease, and the probability of long-term survival approaches 100 %. However, the standard adjuvant treatment for stage I seminoma patients remains controversial, and there is no uniform consensus in the literature. The present study was performed to evaluate treatment preference and outcomes for men with stage I testicular seminoma. From 1997 to 2013, 282 patients with histologically confirmed stage IA and IB testicular seminoma who underwent orchiectomy were included. The outcomes of three management options and survivals were retrospectively analyzed. The prognostic significance of risk factors for relapse on survival was evaluated by univariate and multivariate analysis; in addition, the factors predicting relapse were also evaluated by logistic regression analysis. Of the 282 patients with stage I seminoma, 130 (46.1) received adjuvant radiotherapy (RT), 80 (28.4 %) were treated with adjuvant carboplatin, while the remaining 72 patients (25.5 %) underwent surveillance. At the time of analysis, the median follow-up period of 38.5 months; relapses were observed in 16 patients (22.3 %) on surveillance, in one patient (1.2 %) treated with adjuvant carboplatin and in ten patients (%7.7) who received adjuvant RT. The 5-year disease-free survival (DFS) rate for patients who underwent surveillance was worse than those of patients treated with adjuvant carboplatin and RT (64.2 vs. 97.7 vs. 91.9 %, respectively; p < 0.001). However, the 5-year overall survival (OS) rate for patients on surveillance was similar compared with the adjuvant treatment groups (100 vs. 92.3 vs. 97.4 %, respectively; p = 0.44). Univariate analysis showed that only the treatment approach (surveillance vs. adjuvant carboplatin vs. adjuvant RT) for DFS (p < 0.001), invasion of the rete testis (p = 0.041) and the presence of relapse (p < 0.001) for OS were important prognostic indicators. Multivariate analysis indicated that the treatment strategy for DFS (p < 0.001, HR 0.34) was an independent prognostic factor. Furthermore, a logistic regression analysis showed that adjuvant treatment was found to be an independent factor for predicting relapse (p = 0.004, odds ratio: 0.39). Our results indicate that adjuvant treatment with carboplatin or RT is associated with improved DFS compared with surveillance for men with stage I testicular seminoma after orchiectomy. Moreover, the treatment strategy is an important prognostic indicator for DFS and a predictive factor for relapse. Although adjuvant treatment, especially carboplatin, seems to be a suitable treatment for patients with risk factors for relapse, surveillance is still feasible and the preferred management option after radical orchiectomy in men with stage I seminoma. More reliable predictive factors are needed to make treatment decisions.
dc.identifier.citationBilici, A., Öztürk, T., Türkmen, E., Odabaş, H., Cihan, Ş., Selçukbiricik, F. ... Gümüş, M. (2015). Treatment preferences in stage IA and IB testicular seminoma: Multicenter study of anatolian society of medical oncology. World Journal of Urology, 33(10), 1613-1622. https://dx.doi.org/10.1007/s00345-015-1492-9
dc.identifier.doi10.1007/s00345-015-1492-9
dc.identifier.endpage1622
dc.identifier.issn0724-4983
dc.identifier.issn1433-8726
dc.identifier.issue10
dc.identifier.scopusqualityQ1
dc.identifier.startpage1613
dc.identifier.urihttps://dx.doi.org/10.1007/s00345-015-1492-9
dc.identifier.urihttps://hdl.handle.net/20.500.12511/4092
dc.identifier.volume33
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherSpringer
dc.relation.ispartofWorld Journal of Urologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/embargoedAccess
dc.subjectSeminoma
dc.subjectAdjuvant Treatment
dc.subjectRadiotherapy
dc.subjectCarboplatin
dc.subjectSurveillance
dc.subjectSurvival
dc.titleTreatment preferences in stage IA and IB testicular seminoma: Multicenter study of anatolian society of medical oncology
dc.typeArticle

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