Testicular Germ Cell Tumors (TGCTs) represent the most frequent malignant tumour among young male adults. Orchiectomy alone cure 80% of stage I. Standard options after orchiectomy include radiotherapy (RT), chemotherapy (CT) by 1 cycle of carboplatin AUC 7 or active surveillance (SV) for seminomatous GCTs (SGCT) and retroperitoneal lymphadenectomy (RPLND), CT by 1 or 2 cycles of Bleomycine Etoposide Cisplatine (BEP) or active surveillance for nonseminomatous GCTs (NSGCT). Adjuvant treatments decrease the relapse rate after orchiectomy with substantial toxicities without any benefit on overall survival. Recent guidelines accorded utmost importance on SV rather than adjuvants strategies. The main objective of this study was to describe our current practice over the 10 past years in regard of these recommendations.
Data of 50 patients with stage I GCT treated in our institute were collected between 2006 and 2016. Demographic and anatomopathologic data were reported. Clinical practice in our center was analyzed during two periods [2006-2011] and [2012-2016] according to the European Association of Urology Guidelines in 2011.
Patient's median age was 35.3 years. The analysis of clinical practice during the last 10 years showed that in SGCT, main treatment was RT than SV and CT. This option declined over the years (89% between 2006-2010 versus 53% between 2011-2016) whereas SV was more often employed (27% between 2011-2016 versus none between 2006-2010). Surveillance was used for 64% of NSGCT.
In our center, RT was less used over the years for the benefit of SV which is recommended by guidelines.
Bulletin du cancer. 2019 Sep 30 [Epub ahead of print]
Edouard Chanal, Wafa Bouleftour, Aline Guillot, Elise Rowinski, Emilie Bernichon, Lancelot Tremeau, Renaud Lardon, Bertrand Lacroix, Stephane Lorin, Gregory Delorme, Yves Perraud, Corinne Armand, Frederic Levigne, Alexis Vallard, Julien Langrand-Escure, Pierre Fournel, Mery Benoite, Cecile Vassal
Institut de cancérologie Lucien-Newirth, Department of Medical Oncology, Saint-Priest-en-Jarez, France., Institut de cancérologie Lucien-Newirth, Department of Medical Oncology, Saint-Priest-en-Jarez, France. Electronic address: ., CHU de Saint-Étienne, Urology department, Saint-Étienne, France., Clinique mutualiste chirurgicale de Saint-Étienne, Urology department, Saint-Étienne, France., Hôpital Privé de la Loire, Urology department, Loire, France., Institut de cancérologie Lucien-Newirth, Department of Radiotherapy, Saint-Priest-en-Jarez, France.