Reducing the burden of chemotherapy in stage IIB/C testicular seminoma

Abstract

Stage II testicular seminoma is defined by the presence of pure seminoma in the orchiectomy specimen and metastatic retroperitoneal lymph nodes. Chemotherapy or radiotherapy are recommended for low volume (size ≤ 5 cm) while chemotherapy is advised for patients with bulky disease (size > 5 cm). Chemotherapy is based on a combination of etoposide and cisplatin (4 cycles) or bleomycin, etoposide and cisplatin (3 cycles) whatever the size of retroperitoneal lymph nodes. We report two patients who achieved a 2-year sustained disease remission despite a reduced number of chemotherapy cycles because of septic complications or intercurrent viral infection. These observations suggest that new strategies are required to reduce the number of cycles and consequently long-term morbidity.

Keywords

• Testicular cancer
• Germ cell tumor
• Seminoma
• Chemotherapy