[Current developments in surgery and radiotherapy for the treatment of seminoma stage IIA/B].

BACKGROUND

Stage IIA/B seminoma is cured in over 90% of cases with standard therapies (polychemotherapy, large-volume radiotherapy). However, these treatments are associated with potential late toxicities.

MATERIALS AND METHODS

This article addresses current developments from a urological-surgical and radiotherapeutic perspective in the treatment of stage IIA/B seminoma. Current study results are presented, and possible developments are outlined.

RESULTS AND CONCLUSION

Retroperitoneal lymphadenectomy (RLA) has the potential to offer a radiation- and chemotherapy-free treatment alternative. It was investigated in the recently published PRIMETEST, SEMS, and COTRIMS studies. Current clinical research focuses on the choice of template (unilateral vs. bilateral), the surgical approach (open vs. robotic), and the potential use of adjuvant chemotherapy after RLA (ongoing PRIMETEST II study). A combined, de-escalated chemoradiotherapy was evaluated in the SAKK 01/10 study and yielded very good results regarding recurrence-free survival and toxicity. Long-term results are still awaited, as are the results of the study SAKK 01/18.