Abstract
Aim: The aim of this retrospective study was to investigate the clinical role and side effect profile of adjuvant carboplatin in patients with clinical stage one seminoma. Methods: Twenty four patients with stage one seminoma who were treated with carboplatin were assessed retrospectively. Result: 54% (13/24) of patients experienced no acute toxicities with carboplatin.17%(8/24) had grade 1 myelosupression, 8% (2/24)had fatigue and 4%(1/24) had epididymo-orchitis.In terms of long-term toxicities due to carboplatin; 67% (15/24) were well at follow up,13% (3/24) had gastrointestinal toxicity,8% (2/24) had pulmonary changes ,4% (1/24)had grade two fatigue,4%(1/24) had a cardiac event and 4%(1/24) had erectile dysfunction.17% (4/24)had high risk histologic features with a tumour size greater than 4 cm and rete testis involvement.4% (1/24) patient had recurrent disease. 4% (1/24) patient had a second malignancy. All patients were alive at follow up. Conclusions: Our findings suggest that carboplatin is a safe and well tolerated alternative to Active Surveillance in a selected group of patients.
Highlights
Testicular germ cell tumours (GCTs) are the most common malignancy in men between the ages of 15 and 35
Result: 54% (13/24) of patients experienced no acute toxicities with carboplatin.17%(8/24) had grade 1 myelosupression, 8% (2/24)had fatigue and 4%(1/24) had epididymo-orchitis.In terms of long-term toxicities due to carboplatin; 67% (15/24) were well at follow up,13% (3/24) had gastrointestinal toxicity,8% (2/24) had pulmonary changes,4% (1/24)had grade two fatigue,4%(1/24) had a cardiac event and 4%(1/24) had erectile dysfunction.17% (4/24)had high risk histologic features with a tumour size greater than 4 cm and rete testis involvement.4% (1/24) patient had recurrent disease. 4% (1/24) patient had a second malignancy
Our findings suggest that carboplatin is a safe and well tolerated alternative to Active Surveillance in a selected group of patients
Summary
Testicular germ cell tumours (GCTs) are the most common malignancy in men between the ages of 15 and 35. GCTs most commonly arise in the gonads, but they may originate in the retroperitoneum or mediastinum. These exquisitely chemosensitive tumours result in treatment with curative intent regardless of the extent of the disease, with survival rates in Ireland estimated at 96.3% (National cancer registry Ireland, 2012). While the incidence of GCTs in Europe is 6.3/ 100,000 /year (Wilkinson & Read, 1997), Ireland is amongst the highest incidence rates of 7.3/ 100,000/year (National cancer registry Ireland, 2012). Clinical stage one testicular seminoma has a survival rate over 99% (National cancer registry Ireland, 2012; Oldenburg, Martin, & Fossa, 2006). Secondary endpoints include the analysis of incidence of disease recurrence, risk of secondary malignancies and the role of histological features in predicting outcomes
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