Mp37-08 Serum Mirna Predicts Viable Disease Post-chemotherapy in Testicular Non-seminoma Germ Cell Tumor Patients
Year: 2018
Type: article
Abstract: INTRODUCTION AND OBJECTIVES:We thought to evaluate progression-free survival of stage II A/B seminoma patients (pts) undergoing primary retroperitoneal lymph node dissection (RPLND) without adjuvant treatment.Aim is to present interim data of a feasibility study and a phase II trial.METHODS: Prior to the phase II trial, 9 patients have been treated within a pilot feasibility study followed by additional 6 patients since 3.2016 within the prospective phase II trial (NCT 2015053664).All patients received primary retroperitoneal lymph node dissection (open or daVinci assisted) for stage IIA/B seminoma without adjuvant treatment.The data was analyzed for peri-and postoperative outcome including recurrence free survival.The trial will have to accrue 30 pts and was designed to exclude a > 30% recurrence to standard treatment.RESULTS: Since 5.2014 fifteen patients with seminomateous germ cell tumor have been included in both studies, including one patient with an atypical inguinal recurrence and one patient with a 6 cm marker negative recurrence (clinical stage IIC).Primary RPLND was performed in 2 patients (CSIIA), and in 9 patients with early, and 4 patients with late recurrence.4 patients (30.8%) have been pretreated with one cycle of carboplatin, and 9 patients (69.2%) were under active surveillance.5 DaVinci assisted and 10 open RPLNDs were performed with a mean OR time of 142min and a mean blood loss of 89cc, the mean tumor size was 2.7 cm.One patient after DaVinci RPLND developed a ureteral stricture requiring ileal ureter substitute.The mean follow-up is 23 month (range 3-39 month), 11/ 15 patients (73.3%) are recurrence free.4/15 (26.7%) developed a recurrence (3x outside field and 1x inside field) with a mean time to recurrence of 4.5 month.All patients received salvage treatment (3x CTX and 1x radiotherapy) and are currently recurrence free.CONCLUSIONS: Primary RPLND in stage IIA/B seminoma patients is an experimental treatment approach in order to reduce long term toxicity and secondary malignancies.The upper limit for a successful primary RPLND seems to be CS IIA.This kind of surgery should be only performed within clinical trials in high volume referral centers.
Source: The Journal of Urology
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2902554630