ㅤTake-home message from Oliver 2011, published in Journal of Clinical Oncology):
In the management of Stage 1 seminoma:
There was no difference in relapse free rates or rates of contralateral germ cell cancer (GCT) between carboplatin and radiotherapy
Significant reduction of risk of contralateral GCT by 80% with treatment
A high FSH level pretreatment was associated with an 8.6 fold increase in contralateral GCT rate
FSH levels were maintained throughout treatment, suggesting no effect on fertility
One single full dose of carboplatin (7 times area under curve (AUC)) is recommended
ㅤTake-home message from Tandstad 2009, published in Journal of Clinical Oncology):
Lympho-vascular invasion is the most important prognostic factor for risk of relapse in nonseminomatous germ-cell testicular cancer (NSGCT).
The aim of this study was to offer risk-adapted adjuvant treatment with BEP to patients with clinical stage 1 NSGCT to reduce the risk of relapse. Patients were divided into vascular invasion positive (VASC+) and vascular invasion negative (VASC-) groups.
VASC+ patients were recommended short-term adjuvant chemotherapy and could choose between one or two courses of bleomycin, etoposide, and cisplatin (BEP), while VASC- patients could choose between surveillance and one course of BEP.
One course of adjuvant BEP reduces the risk of relapse by 90% in both VASC+ and
VASC- clinical stage 1 NSGCT
ㅤTake-home message from Jones 2005, published in Journal of Clinical Oncology):
This randomised study compared the results of a standard dose of 30 Gy in 15 fractions of radiotherapy with the lower dose of 20 Gy in 10 fractions for stage 1 testicular seminoma.
20 Gy in 10 daily fractions over 2 weeks is an effective management strategy for stage I testicular seminoma. This regimen showed reduced acute morbidity, treatment-related lethargy, and the ability to carry out work at both 4 weeks and 12 weeks of follow-up. Relapse rates at a median follow-up of more than 5 years were similar in both groups.
ㅤTake-home message from De Santis 2004, published in Journal of Clinical Oncology):
2-18 FDG PET (2-18 fluoro-deoxy-D-glucose) positron emission tomography has a high specificity (100%) and positive predictive value (100%) with a good sensitivity (80%) and negative predictive value (96%) in detecting residual seminoma post-treatment with chemotherapy compared to conventional CT scanning and may save patients unnecessary surgery to remove masses with no presence of viable tumour.