AUA 2022: Medium to Long Term Health-Related QoL and Treatment-Related Side-Effects in Patients Treated with a Single Dose of Adjuvant Carboplatin for High-risk Seminoma – Results From a Pilot Study

(  In a podium presentation at the 2022 American Urologic Association Annual Meeting held in New Orleans and virtually, Dr. Cazzaniga discussed medium to long-term health related quality of life and treatment-related side effects of therapy for patients who received a single dose of adjuvant carboplatin (AUC 7) for high-risk stage I seminoma. Rates of these events are thought to be rare, though persisting symptoms and quality of life impact of treatment for patients are poorly defined.

The authors examined data from 32 patients, including patients who received orchidectomy alone (control group) and those who received orchidectomy followed by a single dose Carboplatin AUC 7 (intervention). The authors assessed patient reported health related quality of life (HRQoL) using the validated EQ-5D-5L metric together with a testis cancer specific questionnaire, the EORTC TC26, that has been previously used to study post-treatment side effect severity. To evaluate the medium to long term side effects of treatment all patients included in the study had completed testis cancer treatment 12 to 24 months prior to the administration of the questionnaire.

The authors found that, using the EQ-5D-5L metrics, those patients who received a single dose of adjuvant Carboplatin exhibited low and comparable proportions of impairment in the mobility, self-care, and usual activities domains, as compared to the orchidectomy group (0% Vs 0%; 0% Vs 0%; 0% Vs 5.6%; respectively). In contrast, a greater proportion of the adjuvant Carboplatin group reported pain or discomfort problems (30.8% Vs 21%). In contrast, those patients treated with orchidectomy alone reported a much higher (nearly two-times) rate of anxiety/depression issues (58% Vs 30%).

Using the testis cancer specific EORTC TC26 questions, patients treated with both adjuvant Carboplatin and orchidectomy alone reported identical medium to long term side effects profiles. Patients who received adjuvant treatment reported almost half the rate of uncertainty concerning their future (39% Vs 69%) compared to those who had orchiectomy alone though self-perceived Health status (81.53% Vs 81.15%) was identical.

The authors conclude that the addition of a single dose of adjuvant Carboplatin for high-risk stage1 seminoma does not increase the medium to long term side effects compared to patients with low-risk disease who underwent orchidectomy alone. Notably, the provision of adjuvant carboplatin was associated with higher levels of patient perception of care and reduced anxiety and uncertainty about possible cancer recurrence.

Presented by:  Walter Cazzaniga, MD London, United Kingdom,