Therapy of clinical stage IIA and IIB seminoma: a systematic review
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Therapy of clinical stage IIA and IIB seminoma: a systematic review. / Heinzelbecker, Julia; Schmidt, Stefanie; Lackner, Julia; Busch, Jonas; Bokemeyer, Carsten; Classen, Johannes; Dieing, Annette; Hakenberg, Oliver; Krege, Susanne; Papachristofilou, Alexandros; Pfister, David; Ruf, Christian; Schmelz, Hans; Schmidberger, Heinz; Souchon, Rainer; Winter, Christian; Zengerling, Friedemann; Kliesch, Sabine; Albers, Peter; Oing, Christoph.
In: WORLD J UROL, Vol. 40, No. 12, 12.2022, p. 2829-2841.Research output: SCORING: Contribution to journal › SCORING: Review article › Research
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TY - JOUR
T1 - Therapy of clinical stage IIA and IIB seminoma: a systematic review
AU - Heinzelbecker, Julia
AU - Schmidt, Stefanie
AU - Lackner, Julia
AU - Busch, Jonas
AU - Bokemeyer, Carsten
AU - Classen, Johannes
AU - Dieing, Annette
AU - Hakenberg, Oliver
AU - Krege, Susanne
AU - Papachristofilou, Alexandros
AU - Pfister, David
AU - Ruf, Christian
AU - Schmelz, Hans
AU - Schmidberger, Heinz
AU - Souchon, Rainer
AU - Winter, Christian
AU - Zengerling, Friedemann
AU - Kliesch, Sabine
AU - Albers, Peter
AU - Oing, Christoph
N1 - © 2021. The Author(s).
PY - 2022/12
Y1 - 2022/12
N2 - PURPOSE: The optimal treatment for clinical stage (CS) IIA/IIB seminomas is still controversial. We evaluated current treatment options.METHODS: A systematic review was performed. Only randomized clinical trials and comparative studies published from January 2010 until February 2021 were included. Search items included: seminoma, CS IIA, CS IIB and therapy. Outcome parameters were relapse rate (RR), relapse-free (RFS), overall and cancer-specific survival (OS, CSS). Additionally, acute and long-term side effects including secondary malignancies (SMs) were analyzed.RESULTS: Seven comparative studies (one prospective and six retrospective) were identified with a total of 5049 patients (CS IIA: 2840, CS IIB: 2209). The applied treatment modalities were radiotherapy (RT) (n = 3049; CS IIA: 1888, CSIIB: 1006, unknown: 155) and chemotherapy (CT) or no RT (n = 2000; CS IIA: 797, CS IIB: 1074, unknown: 129). In CS IIA, RRs ranged from 0% to 4.8% for RT and 0% for CT. Concerning CS IIB RRs of 9.5%-21.1% for RT and of 0%-14.2% for CT have been reported. 5-year OS ranged from 90 to 100%. Only two studies reported on treatment-related toxicities.CONCLUSIONS: RT and CT are the most commonly applied treatments in CS IIA/B seminoma. In CS IIA seminomas, RRs after RT and CT are similar. However, in CS IIB, CT seems to be more effective. Survival rates of CS IIA/B seminomas are excellent. Consequently, long-term toxicities and SMs are important survivorship issues. Alternative treatment approaches, e.g., retroperitoneal lymph node dissection (RPLND) or dose-reduced sequential CT/RT are currently under prospective investigation.
AB - PURPOSE: The optimal treatment for clinical stage (CS) IIA/IIB seminomas is still controversial. We evaluated current treatment options.METHODS: A systematic review was performed. Only randomized clinical trials and comparative studies published from January 2010 until February 2021 were included. Search items included: seminoma, CS IIA, CS IIB and therapy. Outcome parameters were relapse rate (RR), relapse-free (RFS), overall and cancer-specific survival (OS, CSS). Additionally, acute and long-term side effects including secondary malignancies (SMs) were analyzed.RESULTS: Seven comparative studies (one prospective and six retrospective) were identified with a total of 5049 patients (CS IIA: 2840, CS IIB: 2209). The applied treatment modalities were radiotherapy (RT) (n = 3049; CS IIA: 1888, CSIIB: 1006, unknown: 155) and chemotherapy (CT) or no RT (n = 2000; CS IIA: 797, CS IIB: 1074, unknown: 129). In CS IIA, RRs ranged from 0% to 4.8% for RT and 0% for CT. Concerning CS IIB RRs of 9.5%-21.1% for RT and of 0%-14.2% for CT have been reported. 5-year OS ranged from 90 to 100%. Only two studies reported on treatment-related toxicities.CONCLUSIONS: RT and CT are the most commonly applied treatments in CS IIA/B seminoma. In CS IIA seminomas, RRs after RT and CT are similar. However, in CS IIB, CT seems to be more effective. Survival rates of CS IIA/B seminomas are excellent. Consequently, long-term toxicities and SMs are important survivorship issues. Alternative treatment approaches, e.g., retroperitoneal lymph node dissection (RPLND) or dose-reduced sequential CT/RT are currently under prospective investigation.
U2 - 10.1007/s00345-021-03873-5
DO - 10.1007/s00345-021-03873-5
M3 - SCORING: Review article
C2 - 34779882
VL - 40
SP - 2829
EP - 2841
JO - WORLD J UROL
JF - WORLD J UROL
SN - 0724-4983
IS - 12
ER -