Session: Publication Only: Genitourinary (Nonprostate) Cancer
Adjuvant chemotherapy with two cycles of cisplatin in stage I seminomas.
Authors: Luis Garcia-Aceituno, Hugo Raul Castro, Cesar Hernandez-Monroy, Noe V. Castro; Instituto Guatemalteco De Seguridad Social, Guatemala, Guatemala
Research Funding:
Background: Radiotherapy or chemotherapy with one cycle of carboplatin are widely accepted as adjuvant treatments in stage I seminomas, however a lot of patients in our country can not afford these treatments. Strict surveillance is also and option, but is highly difficult to achieve it in a proper way. We design this phase II study to evaluate if two cycles of cisplatin are a viable and much affordable adjuvant option in patients with stage I seminomas.
Methods: Patients with stage I seminomas were assigned to receive two adjuvant cycles of cisplatin at a dose of 75 mg/m2 every 21 days. Variables analyzed were relapse free survival, overall survival, age, tumor size, rete testis invasion and adverse events.
Results: 24 patients were enrolled in the study. Median age at diagnosis was 30 years. 14 patients (58.3%) had tumors <4 cm and 41.7%% of the patients (10) had tumors >4 cm. Rete testis invasion was present in 9 patients (37.5%). With a median follow-up of 31 months (12-63 months), only one patient relapsed (4.16% relapse rate). At the time of the analysis relapse free survival was 95.8% and an overall survival of 100%. The most common adverse event was nausea followed by neutropenia in 64% and 29% of the patients respectively. There were no grade 3 or 4 adverse events.
Conclusions: Two cycles of cisplatin as adjuvant treatment for stage I seminomas seems to be an effective and affordable strategy, with a low relapse rate and manageable adverse events.
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