TY  - JOUR
A1  - Dieckmann, Klaus-Peter
A1  - Pokrivcak, Tomas
A1  - Geczi, Lajos
A1  - Niehaus, David
A1  - Dralle-Filiz, Inken
A1  - Matthies, Cord
A1  - Dienes, Tamas
A1  - Zschäbitz, Stefanie
A1  - Paffenholz, Pia
A1  - Gschliesser, Tanja
A1  - Pichler, Renate
A1  - Mego, Michal
A1  - Bader, Pia
A1  - Zengerling, Friedemann
A1  - Heinzelbecker, Julia
A1  - Krausewitz, Philipp
A1  - Krege, Susanne
A1  - Aurilio, Gaetano
A1  - Aksoy, Cem
A1  - Hentrich, Marcus
A1  - Seidel, Christoph
A1  - Törzsök, Péter
A1  - Nestler, Tim
A1  - Majewski, Matthaeus
A1  - Hiester, Andreas
A1  - Buchler, Tomas
A1  - Vallet, Sonia
A1  - Studentova, Hana
A1  - Schönburg, Sandra
A1  - Niedersüß-Beke, Dora
A1  - Ring, Julia
A1  - Trenti, Emanuela
A1  - Heidenreich, Axel
A1  - Wülfing, Christian
A1  - Isbarn, Hendrik
A1  - Pichlmeier, Uwe
A1  - Pichler, Martin
T1  - Single-course bleomycin, etoposide, and cisplatin (1xBEP) as adjuvant treatment in testicular nonseminoma clinical stage 1: outcome, safety, and risk factors for relapse in a population-based study
T2  - Therapeutic Advances in Medical Oncology
N2  - Introduction:
Clinical stage 1 (CS1) nonseminomatous (NS) germ cell tumors involve a 30% probability of relapse upon surveillance. Adjuvant chemotherapy with one course of bleomycin, etoposide, and cisplatin (1xBEP) can reduce this risk to <5%. However, 1xBEP results are based solely on five controlled trials from high-volume centers. We analyzed the outcome in a real-life population.
Patients and Methods:
In a multicentric international study, 423 NS CS1 patients receiving 1xBEP were retrospectively evaluated. Median follow-up was 37 (range, 6–89) months. Primary end points were relapse-free and overall survival evaluated after 5 years. We also looked at associations of relapse with clinico-pathological factors using stratified Kaplan–Meier methods and Cox regression models. Treatment modality and outcome of recurrences were analyzed descriptively.
Results:
The 5-year relapse-free survival rate was 96.2%. Thirteen patients (3.1%; 95% confidence interval, 1.65–5.04%) relapsed after a median time of 13 months, of which 10 were salvaged (77%). Relapses were mostly confined to retroperitoneal nodes. Three patients succumbed, two to disease progression and one to toxicity of chemotherapy. Pathological stage >pT2 was significantly associated with relapse rate.
Conclusion:
The relapse rate of 3.1% found in this population of NS CS1 patients treated with 1xBEP at the routine care level was not inferior to the median rate of 2.3% reported from a meta-analysis of controlled trials. Also, the cure rate of relapses of 77% is consistent with the previously reported rate of 80%. This study clearly shows that the 1xBEP regimen represents a safe treatment for NS CS1 patients.
KW  - Oncology
Y1  - 2022
UR  - https://opus.bibliothek.uni-augsburg.de/opus4/frontdoor/index/index/docId/101482
UR  - https://nbn-resolving.org/urn:nbn:de:bvb:384-opus4-1014821
SN  - 1758-8359
VL  - 14
SP  - 1
EP  - 13
PB  - SAGE Publications
ER  -