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. 2023 Jan 28:49:69-70.
doi: 10.1016/j.euros.2022.06.010. eCollection 2023 Mar.

Stage II Seminoma: Why Chemotherapy Should Remain a Standard

Natacha Naoun  1 , Alice Bernard-Tessier  1 , Karim Fizazi  1
Affiliations

Stage II Seminoma: Why Chemotherapy Should Remain a Standard

Natacha Naoun et al. Eur Urol Open Sci. .

Abstract

Chemotherapy (three cycles of bleomycin + etoposide + cisplatin or four of etoposide + cisplatin) cures the vast majority of stage II seminomas. Retroperitoneal lymph node dissection (RPLND) is safe in early-stage seminoma, but the risk of relapse is not negligible. Long-term chemotherapy side effects are a reality but may be reduced using de-escalation strategies such as in the SEMITEP trial design, motivated by growing interest in survivorship. RPLND may be an option for well-informed select patients who understand that it may be associated with a higher rate of relapse than with cisplatin-based chemotherapy. In any case, local and systemic treatment should not be performed outside high-volume centers.

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