Abstract 324P
Background
Testicular cancer is rare globally and India has one of the lowest incidence rates (0.5 per 100,000 men). Stage 1 seminoma is treated with high inguinal orchiectomy (HIO) followed by chemotherapy, radiation therapy (RT) or active surveillance (AS).
Methods
This was a retrospective analysis of a prospectively collected dataset of patients with seminoma treated at a comprehensive cancer care centre in India. Adolescent and adult males with an eastern co-operative oncology group (ECOG) performance status (PS) 0-2 and stage 1 seminoma were included. The relapse-free survival (RFS) was calculated from date of diagnosis to date of relapse and overall survival (OS) was from date of diagnosis to date of death. Kaplan-Meier method was used for estimation of median RFS and OS. Impact of different treatment options was calculated using log-rank method.
Results
A total of 114 patients were analysed. The median age was 39 years (IQR: 32-48 years) (Table). Chemotherapy (single agent carboplatin) was offered to 66 (57.9%) patients which was well tolerated. Nine (7.9%) patients had radiological relapse while 4 (3.5%) of them had clinical relapse as well. Stage 2 or 3 at relapse was seen in 8 (7%) patients. Bleomycin, etoposide and cisplatin (BEP) was the most common regimen offered on relapse. The median follow-up was 70.6 months (95% CI: 59.1 – 82 months). The median time to first relapse was 15.6 months. The median RFS was 107.7 months (95% CI: 102.5 – 112.8 months). The 1-year, 2-year and 5-year RFS were 97.3%, 95.5% and 92.4% respectively. The median OS was 114.9 months (95% CI: 113.2 – 116.6 months). The 2-year, 5-year and 8-year OS were 100%, 98.9% and 98.9%. There was no statistically significant difference in RFS (p=0.355) or OS (p=0.684) based on treatment offered at baseline. Table: 324P
Baseline characteristics and treatment at relapse
| Characteristics | All patients (n = 114) |
| Age group | |
| Less than 30 | 22 (19.3%) |
| 30 – 50 | 73 (64%) |
| More than 50 | 19 (16.7%) |
| Stage | |
| IA | 73 (64%) |
| IB | 41 (36%) |
| Orchiectomy | |
| High-inguinal | 105 (92.1%) |
| Trans-scrotal | 9 (7.9%) |
| Treatment | |
| Active surveillance | 32 (28.1%) |
| Chemotherapy | 66 (57.9%) |
| Radiation therapy | 16 (14%) |
| Radiation dose | |
| 20 Gy/10# | 8 (7%) |
| 25.2 Gy/14# | 5 (4.4%) |
| 30 Gy/15# | 3 (2.6%) |
| Treatment at relapse | |
| Chemotherapy | 8 (7%) |
| Surgery | 1 (0.9%) |
| Chemotherapy at relapse | |
| BEP (Bleomycin, etoposide and cisplatin) | 4 (3.5%) |
| EP (Etoposide and cisplatin) | 2 (1.8%) |
| VIP (Etoposide, ifosfamide and cisplatin) | 1 (0.9%) |
| PVB (Cisplatin, vinblastine and bleomycin) | 1 (0.9%) |
Conclusions
To our knowledge, this is the largest database of stage 1 seminoma from India. AS, chemotherapy or RT are acceptable forms of treatment in stage 1 seminoma post HIO.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
A. Dhanawat.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.