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SHR Neuro Krebs Kardio Lipid Stoffw Microb

Dieckmann, KP; Pokrivcak, T; Geczi, L; Niehaus, D; Dralle-Filiz, I; Matthies, C; Dienes, T; Zschabitz, S; Paffenholz, P; Gschliesser, T; Pichler, R; Mego, M; Bader, P; Zengerling, F; Heinzelbecker, J; Krausewitz, P; Krege, S; Aurilio, G; Aksoy, C; Hentrich, M; Seidel, C; Torzsok, P; Nestler, T; Majewski, M; Hiester, A; Buchler, T; Vallet, S; Studentova, H; Schonburg, S; Niedersuss-Beke, D; Ring, J; Trenti, E; Heidenreich, A; Wulfing, C; Isbarn, H; Pichlmeier, U; Pichler, M.
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
THER ADV MED ONCOL. 2022; 14: 17588359221086813 Doi: 10.1177/17588359221086813 [OPEN ACCESS]
Web of Science PubMed PUBMED Central FullText FullText_MUG


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Pichler Martin

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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.

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