RT Journal Article
T1 Prognostic factors for relapse in stage I seminoma: a new nomogram derived from three consecutive, risk-adapted studies from the Spanish Germ Cell Cancer Group (SGCCG)
A1 Aparicio, Jorge
A1 Maroto, Pablo
A1 García del Muro, Xavier
A1 Sánchez-Muñoz, Alfonso
A1 Guma, Josep
A1 Margelí, Mireia
A1 Sáenz, Alberto
A1 Sagastibelza, Naiara
A1 Castellano, Daniel
A1 Arranz-Arija, José Ángel
A1 Hervás, David
A1 Bastús, Romá
A1 Fernández-Aramburo, Antonio
A1 Sastre, Javier
A1 Terrasa, Josefa
A1 Lopez-Brea, Marta
A1 Dorca, Joan
A1 Almenar, Daniel
A1 Carles, J.
A1 Hernández, Álvaro
A1 Germá-Lluch, José Ramón
K1 Testículos - Cáncer - Recidiva
K1 Marcadores tumorales
K1 Cáncer - Diagnóstico
AB Background: We aimed to analyze prognostic factors for relapse in stage I seminoma managed by either active surveillance or adjuvant chemotherapy, and to describe the long-term patterns of recurrence in both groups.Patients and methods: From 1994 to 2008, 744 patients were included in three consecutive, prospective risk-adapted studies by the Spanish Germ Cell Cancer Group. Low-risk patients were managed by surveillance and high-risk patients were given two courses of adjuvant carboplatin. Relapses were treated mainly with chemotherapy. Patient age, tumor size, histological variant, pT staging, rete testis invasion, and preoperative serum BHCG levels were assessed for prediction of disease-free survival (DFS).Results: After a median follow-up of 80 months, 63 patients (11.1%) have relapsed: 51/396 (14.8%) on surveillance and 12/348 (3.2%) following adjuvant carboplatin. Actuarial overall 5-year DFS was 92.3% (88.3% for surveillance versus 96.8% for chemotherapy, P = 0.0001). Median time to relapse was 14 months. Most recurrences were located at retroperitoneum (86%), with a median tumor size of 26 mm. All patients were rendered disease-free with chemotherapy (92%), radiotherapy (5%), or surgery followed by chemotherapy (3%). A nomogram was developed from surveillance patients that includes two independent, predictive factors for relapse: rete testis invasion and tumor size (as a continuous variable).Conclusion: Long-term follow-up confirms the risk-adapted approach as an effective option for patients with stage I seminoma. The pattern of relapses after adjuvant chemotherapy is similar to that observed following surveillance. A new nomogram for prediction of DFS among patients on surveillance is proposed. Rete testis invasion and tumor size should be taken into account when considering the administration of adjuvant carboplatin. Prospective validation is warranted.
PB Elsevier
YR 2014
FD 2014-09-10
LK https://hdl.handle.net/10630/31194
UL https://hdl.handle.net/10630/31194
LA eng
NO Aparicio J, Maroto P, García Del Muro X, Sánchez-Muñoz A, Gumà J, Margelí M, Sáenz A, Sagastibelza N, Castellano D, Arranz JA, Hervás D, Bastús R, Fernández-Aramburo A, Sastre J, Terrasa J, López-Brea M, Dorca J, Almenar D, Carles J, Hernández A, Germà JR. Prognostic factors for relapse in stage I seminoma: a new nomogram derived from three consecutive, risk-adapted studies from the Spanish Germ Cell Cancer Group (SGCCG). Ann Oncol. 2014 Nov;25(11):2173-2178. doi: 10.1093/annonc/mdu437. Epub 2014 Sep 10. PMID: 25210015.
NO Este artículo ha sido publicado en Annals of Oncology. Esta versión tiene Licencia Creative Commons CC-BY.
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RD 20 ene 2026