854P - Treatment outcome and patterns of relapse following adjuvant carboplatin for stage 1 seminoma: Results from a 17 year UK experience

Date 27 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anti-Cancer Agents & Biologic Therapy
Germ Cell Tumours
Presenter Caroline Chau
Citation Annals of Oncology (2014) 25 (suppl_4): iv280-iv304. 10.1093/annonc/mdu337
Authors C. Chau1, M. Wheater2, M. Fehr3, J. Bennett4, C. Lee5, S. Crabb5, R. Cathomas6, T. Geldart4
  • 1Clinical Research Facility, NIHR Wellcome Trust, University of Southampton, SO16 6YD - Southampton/GB
  • 2Medical Oncology, University Hospital Southampton, SO16 6YD - Southampton/GB
  • 3Medical Oncology And Haematology, Kantonsspital St. Gallen, 9007 - St. Gallen/CH
  • 4Department Of Oncology And Haematology, Royal Bournemouth Hospital, BH7 7DW - Bournemouth/GB
  • 5Cancer Sciences Unit, University of Southampton Faculty of Medicine, SO16 6YD - Southampton/GB
  • 6Medizinische Onkologie, Kantonsspital Graubünden, 7000 - Chur/CH

Abstract

Aim

The prognosis for stage 1 seminoma is excellent with a cure rate approaching 100%, but without adjuvant therapy, approximately 15-20% of patients may relapse and require salvage treatment. The TE19 trial confirmed the efficacy of a single dose of adjuvant carboplatin (AUC 7) in reducing recurrence rate. This study reviews our regional experience, with a focus on the presentation, management and outcome of relapsed patients.

Methods

A retrospective clinical database was constructed for patients who have received one cycle of adjuvant carboplatin (AUC 7) between 1996 and 2013 for stage 1 seminoma. Tumour characteristics, clinical outcomes and patient relapse were evaluated.

Results

518 patients were eligible for inclusion. All patients underwent nuclear medicine measurement of GFR. Median age of diagnosis was 38 (range 18 – 73). Median tumour size was 32mm (range 4 – 110) and 57% had rete testis invasion. Median time from orchidectomy to chemotherapy was 44.5 days (range 10 – 174). 18 patients (3.5%) presented with bilateral disease or developed a contralateral germ cell tumour during follow up; median 94 months (range 0 – 265). With a median follow up of 43.2 months (range 0 – 199), 22 patients (4.2%) have relapsed. Median time to relapse was 22.4 months (range 11 – 108) with the majority of patients (13/518; 2.5%) relapsing within 2 years. Relapse beyond 4 years was very uncommon (4/518: <1%). All but one patient relapsed with good prognosis metastatic disease. 14/22 patients (64%) had asymptomatic relapse detected at planned follow up. Of the 8/22 patients with symptomatic relapse, 4 presented acutely at Emergency Department. Retroperitoneal nodes were the main site of relapse (82%). 18 patients (82%) received salvage chemotherapy and 4 salvage radiotherapy. 4 patients had a second relapse and one had a third relapse. There were no seminoma related deaths.

Conclusions

This is, to our knowledge, the biggest non-trial series describing the clinical outcome and relapse data of patients with stage 1 seminoma treated with a single cycle of adjuvant carboplatin chemotherapy. Our results confirm the excellent prognosis for these patients with outcomes similar to those of prospective clinical trials.

Disclosure

All authors have declared no conflicts of interest.