title: Two cycles of adjuvant carboplatin in stage I seminoma: 8-year experience by the Hellenic Cooperative Oncology Group (HECOG).
abstract: OBJECTIVE
  Following the establishment of adjuvant carboplatin in stage I testicular seminoma as a standard, we adopted this treatment for all stage I seminoma patients. We report our 8-year experience and compare these results with our previous adjuvant etoposide/cisplatin (EP) strategy.
  
  
  METHODS
  Patients with stage I seminoma, treated with adjuvant carboplatin and with a minimum follow-up of 1 year, were included. Two cycles of carboplatin [area under the curve (AUC) 6] were administered.
  
  
  RESULTS
  A total of 138 patients with median age of 34 years, treated from September 2003 to December 2011, were selected. There were 5 relapses [5-year relapse-free rate (RFR) 96.8 % (95 % confidence interval 91.6-98.8)]: 3 relapses at retroperitoneal lymph nodes, 1 relapse at the adrenal gland, and 1 isolated brain metastasis. Four patients with relapse were cured with salvage chemotherapy. All patients with relapse had tumor diameter ≥4 cm and/or age ≤34 years. Patients with at least 1 of the above risk factors (n = 111) had a significantly higher relapse rate compared with a similar population (n = 64) treated with 2 cycles of adjuvant EP: 5-year RFR was 95 % (SE 2 %) versus 100 % (SE 0 %), (p = 0.067).
  
  
  CONCLUSIONS
  Age and tumor diameter were associated with relapse in stage I seminoma treated with adjuvant carboplatin. Although adjuvant carboplatin in patients with age ≤34 and/or tumor diameter ≥4 cm is associated with higher relapse rates than EP, the prognosis of these patients is excellent, and therefore, the use of less toxic treatment is justified.
authors.affiliation: Oncology Unit, Department of Clinical Therapeutics, University of Athens, School of Medicine, Alexandra Hospital, 80 Vas Sofias Ave, 11528, Athens, Greece. koutsoukos.k@gmail.com.
authors.forename: Konstantinos
authors.identifier: http://orcid.org/0000-0002-1710-125X
authors.initials: K
authors.lastname: Koutsoukos
authors.affiliation: Oncology Unit, Department of Clinical Therapeutics, University of Athens, School of Medicine, Alexandra Hospital, 80 Vas Sofias Ave, 11528, Athens, Greece.
authors.forename: Kimon
authors.initials: K
authors.lastname: Tzannis
authors.affiliation: Second Department of Medical Oncology, "Metropolitan" Hospital, Piraeus, Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Christodoulou
authors.affiliation: Department of Medical Oncology, "Papageorgiou" Hospital, Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece.
authors.forename: Vasilios
authors.initials: V
authors.lastname: Karavasilis
authors.affiliation: Second Department of Medical Oncology, Hygeia Hospital, Athens, Greece.
authors.forename: Charalambos
authors.initials: C
authors.lastname: Bakoyiannis
authors.affiliation: Division of Oncology, Department of Medicine, University Hospital, University of Patras Medical School, Patras, Greece.
authors.forename: Thomas
authors.initials: T
authors.lastname: Makatsoris
authors.affiliation: Department of Medical Oncology, University Hospital of Larissa, University of Thessaly School of Medicine, Larissa, Greece.
authors.forename: C N
authors.initials: CN
authors.lastname: Papandreou
authors.affiliation: Oncology Section, Second Department of Internal Medicine, "Hippokration" Hospital, Athens, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Pectasides
authors.affiliation: Oncology Unit, Department of Clinical Therapeutics, University of Athens, School of Medicine, Alexandra Hospital, 80 Vas Sofias Ave, 11528, Athens, Greece.
authors.forename: Meletios A
authors.initials: MA
authors.lastname: Dimopoulos
authors.affiliation: Oncology Unit, Department of Clinical Therapeutics, University of Athens, School of Medicine, Alexandra Hospital, 80 Vas Sofias Ave, 11528, Athens, Greece.
authors.forename: Aristotelis
authors.initials: A
authors.lastname: Bamias
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000627:therapeutic use; D005047:Etoposide / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D012189:Retrospective Studies; D018239:Seminoma / Q000188:drug therapy* / Q000473:pathology; D013736:Testicular Neoplasms / Q000188:drug therapy* / Q000473:pathology; D013997:Time Factors
chemical_list: D000970:Antineoplastic Agents; D005047:Etoposide; D016190:Carboplatin; D002945:Cisplatin
keywords: Seminoma; Stage I; Two cycles of carboplatin