Treatment of stage-1 seminomas

摘要

abstract_textpDisease-free survival in testicular seminoma is approaching 100. Cure can be achieved by three different established treatment strategies. Adjuvant radiotherapy of the para-aortic lymph nodes (total dose of 20 Gy) and adjuvant chemotherapy with carboplatin (one cycle AUC 7) are equally effective in reducing the risk for recurrence after orchiectomy from 20 to approximately 3-5. Adjuvant treatment can be omitted if the primary tumor shows favourable risk factors (tumor 4 cm, absence of rete testis invasion). Instead of adjuvant treatment, close follow-up with regular diagnostic imaging of the retroperitoneal lymph nodes is performed ("wait and see"). Nearly all patients who suffer a recurrence can be cured by salvage therapy. The decision of which treatment strategy will be adequate for an individual patient depends on the risk factors and possible late effects of adjuvant treatment./p/abstract_text