Outcomes of surveillance versus adjuvant chemotherapy for patients with stage IA and IB nonseminomatous testicular germ cell tumors

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dc.authoridSevinç, Alper/0000-0002-0499-8918
dc.authoridOdabas, Hatice/0000-0002-5757-4705
dc.authoridbayoglu, ibrahim vedat/0000-0002-0481-1084
dc.authoridBilici, Ahmet/0000-0002-3192-456X
dc.authoridCihan, Şener/0000-0002-3960-4982
dc.authoridCihan, Şener/0000-0002-3594-3661
dc.authoridOven, Bala Basak/0000-0002-9921-4089
dc.authorwosidSevinç, Alper/KPA-4519-2024
dc.authorwosidOdabas, Hatice/HOH-1716-2023
dc.authorwosidturan, nedim/GXG-8035-2022
dc.authorwosidbayoglu, ibrahim vedat/HKN-8074-2023
dc.authorwosidBilici, Ahmet/E-2062-2018
dc.authorwosidGumus, Mahmut/HTO-4176-2023
dc.authorwosidGumus, Mahmut/C-7135-2008
dc.contributor.authorGumus, Mahmut
dc.contributor.authorBilici, Ahmet
dc.contributor.authorOdabas, Hatice
dc.contributor.authorUstaalioglu, Bala Basak Oven
dc.contributor.authorKandemir, Nurten
dc.contributor.authorDemirci, Umut
dc.contributor.authorCihan, Sener
dc.date.accessioned2024-06-12T11:15:38Z
dc.date.available2024-06-12T11:15:38Z
dc.date.issued2017
dc.departmentTrakya Üniversitesien_US
dc.description.abstractBackground Currently, it is accepted that risk assessment of clinical stage I (CS I) nonseminomatous germ cell tumors (NSGCT) patient is mainly dependent on the presence of lymphovascular invasion (LVI). Initial active surveillance, adjuvant chemotherapy and retroperitoneal lymph node dissection (RPLND) are acceptable treatment options for these patients, but there is no uniform consensus. The purpose of this study was to compare outcomes of active surveillance with adjuvant chemotherapy. Methods A total of 201 patients with CS I NSGCT after orchiectomy were included. Outcomes of active surveillance and adjuvant chemotherapy were retrospectively analyzed. The prognostic significance of risk factors for survival and relapse was evaluated. Results Of the 201 patients, 110 (54.7%) received adjuvant chemotherapy, while the remaining 91 patients (45.3%) underwent surveillance. Relapses were significantly higher for patients underwent surveillance compared to adjuvant chemotherapy group (18.3 vs. 1.2%, p < 0.001). The 5-year relapse-free survival (RFS) rate for patients who were treated with adjuvant chemotherapy was significantly better than those of patients underwent surveillance (97.6 vs. 80.8%, respectively; p < 0.001). Univariate analysis showed that the presence of LVI (p = 0.01) and treatment option (p < 0.001) were prognostic factors for RFS and pT stage (p = 0.004) and invasion of rete testis (p = 0.004) and the presence of relapse (p < 0.001) were significant prognostic factors for OS. Multivariate analysis revealed that the treatment strategy was an independent prognostic factor for RFS (p < 0.001, HR 0.54). A logistic regression analysis demonstrated that treatment options (p = 0.031), embryonal carcinoma (EC) > 50% (p = 0.013) and tumor diameter (p = 0.016) were found to be independent factors for predicting relapse. Conclusion Our results indicate that adjuvant chemotherapy is associated with improved RFS compared with surveillance for CS I NSGCT patients. Moreover, the treatment strategy is an important prognostic indicator for RFS and a predictive factor for relapse. Although adjuvant chemotherapy seems to be a suitable treatment for patients with risk factors for relapse, surveillance is still preferred management option.en_US
dc.identifier.doi10.1007/s00345-016-1964-6
dc.identifier.endpage1110en_US
dc.identifier.issn0724-4983
dc.identifier.issn1433-8726
dc.identifier.issue7en_US
dc.identifier.pmid27812752en_US
dc.identifier.scopus2-s2.0-84994323106en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage1103en_US
dc.identifier.urihttps://doi.org/10.1007/s00345-016-1964-6
dc.identifier.urihttps://hdl.handle.net/20.500.14551/23994
dc.identifier.volume35en_US
dc.identifier.wosWOS:000404154000013en_US
dc.identifier.wosqualityQ2en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherSpringeren_US
dc.relation.ispartofWorld Journal Of Urologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectStage Ien_US
dc.subjectNonseminomatous Germ Cell Tumoren_US
dc.subjectTesticular Canceren_US
dc.subjectChemotherapyen_US
dc.subjectSurveillanceen_US
dc.subjectLymph-Node Dissectionen_US
dc.subjectTerm-Follow-Upen_US
dc.subjectCisplatin Chemotherapyen_US
dc.subjectTestis Canceren_US
dc.subjectRisken_US
dc.subjectBleomycinen_US
dc.subjectEtoposideen_US
dc.subjectManagementen_US
dc.subjectTrialen_US
dc.titleOutcomes of surveillance versus adjuvant chemotherapy for patients with stage IA and IB nonseminomatous testicular germ cell tumorsen_US
dc.typeArticleen_US

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