TY - JOUR
T1 - A risk-adapted study of cisplatin and etoposide, with or without ifosfamide, in patients with metastatic seminoma
T2 - Results of the GETUG S99 multicenter prospective study
AU - Fizazi, Karim
AU - Delva, Rémi
AU - Caty, Armelle
AU - Chevreau, Christine
AU - Kerbrat, Pierre
AU - Rolland, Frederic
AU - Priou, Frank
AU - Geoffrois, Lionnel
AU - Rixe, Olivier
AU - Beuzeboc, Philippe
AU - Malhaire, Jean Pierre
AU - Culine, Stephane
AU - Aubelle, Marie Stephanie
AU - Laplanche, Agnes
PY - 2014/2/1
Y1 - 2014/2/1
N2 - Background Whether patients with good prognosis and intermediate/poor prognosis advanced seminoma should be treated differently has not been defined. Objective To assess a risk-adapted chemotherapy regimen in patients with advanced seminoma. Design, setting, and participants A total of 132 patients were included in this prospective study. Patients with a good prognosis according to the International Germ Cell Cancer Collaboration Group (IGGCCG) were treated with four cycles of cisplatin-etoposide (EP). Patients with an intermediate prognosis according to the IGCCCG (or a poor prognosis according to the Medical Research Council classification) were treated with four cycles of VIP (EP and ifosfamide) and granulocyte colony-stimulating factor (G-CSF). Outcome measurements and statistical analysis Survival curves were estimated using the Kaplan-Meier method. Results and limitations The median follow-up was 4.5 yr (range: 0.4-11.6 yr). Among 108 patients (82%) with a good prognosis who received EP, grade 3-4 toxicity included neutropenia (47%) and neutropenic fever (12%). Among the 24 patients (18%) with an intermediate/poor prognosis who received VIP plus G-CSF, toxicity included grade 3-4 neutropenia (36%), neutropenic fever (23%), thrombocytopenia (23%), anemia (23%), and a toxicity-related death (n = 1; 4%). The 3-yr progression-free survival (PFS) rate was 93% (range: 85-97%) in the good prognosis group and 83% (range: 63-93%) in the intermediate/poor prognosis group (p = 0.03 for PFS). The 3-yr overall survival (OS) rate was 99% (range: 92-100%) and 87% (range: 67-95%), respectively (p < 0.005 for OS). Only four patients died of seminoma or its treatment. Conclusions A risk-adapted chemotherapy policy for advanced seminoma yielded an excellent outcome with a 3-yr OS rate of 96%.
AB - Background Whether patients with good prognosis and intermediate/poor prognosis advanced seminoma should be treated differently has not been defined. Objective To assess a risk-adapted chemotherapy regimen in patients with advanced seminoma. Design, setting, and participants A total of 132 patients were included in this prospective study. Patients with a good prognosis according to the International Germ Cell Cancer Collaboration Group (IGGCCG) were treated with four cycles of cisplatin-etoposide (EP). Patients with an intermediate prognosis according to the IGCCCG (or a poor prognosis according to the Medical Research Council classification) were treated with four cycles of VIP (EP and ifosfamide) and granulocyte colony-stimulating factor (G-CSF). Outcome measurements and statistical analysis Survival curves were estimated using the Kaplan-Meier method. Results and limitations The median follow-up was 4.5 yr (range: 0.4-11.6 yr). Among 108 patients (82%) with a good prognosis who received EP, grade 3-4 toxicity included neutropenia (47%) and neutropenic fever (12%). Among the 24 patients (18%) with an intermediate/poor prognosis who received VIP plus G-CSF, toxicity included grade 3-4 neutropenia (36%), neutropenic fever (23%), thrombocytopenia (23%), anemia (23%), and a toxicity-related death (n = 1; 4%). The 3-yr progression-free survival (PFS) rate was 93% (range: 85-97%) in the good prognosis group and 83% (range: 63-93%) in the intermediate/poor prognosis group (p = 0.03 for PFS). The 3-yr overall survival (OS) rate was 99% (range: 92-100%) and 87% (range: 67-95%), respectively (p < 0.005 for OS). Only four patients died of seminoma or its treatment. Conclusions A risk-adapted chemotherapy policy for advanced seminoma yielded an excellent outcome with a 3-yr OS rate of 96%.
KW - Chemotherapy
KW - Prognostic factors
KW - Seminoma
UR - http://www.scopus.com/inward/record.url?scp=84891824431&partnerID=8YFLogxK
U2 - 10.1016/j.eururo.2013.09.004
DO - 10.1016/j.eururo.2013.09.004
M3 - Article
C2 - 24094847
AN - SCOPUS:84891824431
SN - 0302-2838
VL - 65
SP - 381
EP - 386
JO - European Urology
JF - European Urology
IS - 2
ER -