Stage IIA and IIB testicular seminoma treated post-orchiectomy with
					radiation therapy versus other approaches: a population-based analysis of 241
					patients

Ahmed, Kamran A.; Wilder, Richard B.

doi:10.1590/S1677-5538.IBJU.2015.01.11

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Sumário

ORIGINAL ARTICLE • Int. braz j urol 41 (1) • jan-feb 2015 • https://doi.org/10.1590/S1677-5538.IBJU.2015.01.11 copy

Stage IIA and IIB testicular seminoma treated post-orchiectomy with radiation therapy versus other approaches: a population-based analysis of 241 patients

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objectives

To evaluate post-orchiectomy utilization of radiation therapy (RT) versus other management approaches in stage IIA and IIB testicular seminoma patients.

Materials and Methods

Two hundred and forty-one patients with stage IIA and IIB testicular seminoma were identified between 1988 and 2003 using the Surveillance, Epidemiology, and End Results (SEER) database.

Results

Median follow-up was 10 years. Patients with stage IIA disease underwent RT more frequently than those with stage IIB disease (72% vs. 46%, respectively; P<0.001). There was no significant change in RT utilization for stage IIA or IIB disease between 1988 and 2003 (P = 0.89).

Conclusions

Between 1988 and 2003, stage IIA patients underwent RT more often than stage IIB patients in the United States. There was no significant change in RT utilization for stage IIA or IIB disease during this time period. Based on reports describing excellent progression-free survival with cisplatin-based chemotherapy, this approach has increased in popularity since 2003 and may eventually become the most popular treatment approach for both stage IIA and IIB testicular seminoma.

Testicular Neoplasms; Seminoma; Radiotherapy; Antineoplastic Agents

	All Patients (n = 241)		Radiotherapy (n = 136)		No Radiotherapy (n = 105)

Characteristic	n	%	n	%	n	%	P
Age (years)
18-39	139	58%	76	55%	63	45%	0.52
40-76	102	42%	60	59%	42	41%
Marital Status
Single	97	40%	52	54%	45	46%	0.59
Married	125	52%	75	60%	50	40%
Divorced	16	7%	8	50%	8	50%
Unknown	3	1%	1	33%	2	67%
Race
White	219	91%	127	58%	92	42%	0.12
Non-White	22	9%	9	41%	13	59%
Year of Diagnosis
1988-1991	14	6%	7	50%	7	50%	0.89
1992-1995	43	18%	23	53%	20	47%
1996-1999	52	22%	31	60%	21	40%
2000-2003	132	54%	75	56%	57	44%
Educational Level							0.47
Low	65	27%	37	57%	28	43%
Intermediate	102	42%	56	55%	46	45%
High	74	31%	43	58%	31	42%
Primary Tumor (T)
T1	150	62%	96	64%	54	36%	<0.001
T2	39	16%	23	59%	16	41%
T3	18	7%	3	16%	15	84%
T4	5	2%	3	60%	2	40%
TX	29	12%	11	38%	18	62%
Regional Lymph Nodes
N1*	96	40%	69	72%	27	28%	<0.001
N2†	145	60%	67	46%	78	54%

A
Cause of Death (n=9)	Radiotherapy (n=69)	No Radiotherapy (n=27)
Testicular Cancer	2	2
Lung Disease	1	1
Acute Myeloid Leukemia	0	1
Accident	0	1
Unknown	0	1
B

Cause of Death (n=13)	Radiotherapy (n=67)	No Radiotherapy (n=78)

Unknown	1	3
Testicular Cancer	1	2
Heart Disease	2	1
Lung Disease	1	0
Infection	0	1
Colon Cancer	0	1

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[1] Correspondence address: Richard B. Wilder, MD. Department of Radiation Oncology. H. Lee Moffitt Cancer Center and Research Institute. 12902 Magnolia Dr. Tampa, FL, 33612, USA. Fax: + 1 813 745-7231. E-mail: richard.wilder@moffitt.org