title: Retrospective multicentre study of carboplatin monotherapy for clinical stage I seminoma.
abstract: OBJECTIVE
  • To evaluate, in a retrospective multicentre study, the long-term oncological efficacy and morbidity of using carboplatin as an alternative treatment for patients with clinical stage I seminoma.
  
  
  METHODS
  • Patients with clinical stage I seminoma treated with two cycles of adjuvant single-agent carboplatin (400 mg/m² body surface) from February 1990 until September 2008 were retrospectively identified. • A database was created (including information on patient characteristics, initial tumour staging, tumour marker levels, follow-up, oncological outcome, treatment side effects and long-term side effects), descriptive analyses were performed and the data were compared with those available in the literature.
  
  
  RESULTS
  • Of 282 stage I seminomas identified in 276 patients, risk factors for progression (pT2/3, vessel invasion or tumour diameter ≥ 4 cm) were detected in 48.2% of tumours. • Chemotherapy was well tolerated, with patients experiencing only mild nausea. Bone marrow suppression was common (leucopaenia in 36.7% and thrombocytopaenia in 50.5% of patients, mainly grade 1/2). Neither neutropenic fever, nor any bleeding complication occurred. • During a mean follow-up of 75 months, three patients (1.06%) developed a retroperitoneal recurrence within the first 2 years after receiving adjuvant treatment and were salvaged by cisplatin-based chemotherapy. A contralateral second testicular germ cell tumour was diagnosed in five patients.
  
  
  CONCLUSIONS
  • Two cycles of carboplatin monotherapy are highly effective and very well tolerated by all patients. The frequency of contralateral tumours appears to be reduced. • Despite the lack of a randomized trial, the available data in the literature suggest that the administration of two cycles instead of one cycle could lead to a reduction in recurrence rates of ≈50%.
authors: Medical University Innsbruck - Urology, Innsbruck, Austria. hannes.steiner@uki.at
authors: Hannes
authors: H
authors: Steiner
authors: Karl
authors: K
authors: Scheiber
authors: Andreas P
authors: AP
authors: Berger
authors: Patrick
authors: P
authors: Rein
authors: Alfred
authors: A
authors: Hobisch
authors: Josef
authors: J
authors: Aufderklamm
authors: Stefania
authors: S
authors: Pilloni
authors: Brigitte
authors: B
authors: Stoehr
authors: Friedrich
authors: F
authors: Aigner
authors: Andreas
authors: A
authors: Fritzer
authors: Florian
authors: F
authors: Zangerl
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D016190:Carboplatin / Q000009:adverse effects / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D004812:Epidemiologic Methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009919:Orchiectomy; D018239:Seminoma / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D013736:Testicular Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D016190:Carboplatin