Surgery proves effective alternative to chemotherapy and radiation for early metastatic testicular cancer (81% cure rate and 100% with later therapy)

Medical Xpress / University of Southern California / Journal of Clinical Oncology ^ | Match 30, 2023 | Siamak Daneshmand et al

[ConservativeMind]

A newly published study paves the way for some patients with testicular cancer to avoid chemotherapy and radiation.

Seminoma is a slow-growing form of testicular cancer that, if untreated, typically metastasizes (spreads) to lymph nodes in an area behind the abdomen lining called the retroperitoneum. The standard treatment for patients at this stage is chemotherapy and radiation to shrink and kill the cancerous lymph nodes.

While effective, chemotherapy and radiation are associated with long-term side effects.

Now, however, the results of a multi-institutional clinical trial show that surgically removing the affected lymph nodes in the retroperitoneum is an effective alternative to chemotherapy and radiation with fewer long-term side effects.

"We found that the majority of participants in the study were cured with surgery alone," said Sia Daneshmand, MD.

Testicular cancer is generally a treatable cancer that most commonly affects men ages 15-35. When testicular cancer only spreads to the retroperitoneum, it is classified as early metastatic or stage 2 seminoma.

The procedure to remove lymph nodes from the retroperitoneum—known as a retroperitoneal lymphadenopathy—is an established treatment for metastatic testicular cancer when chemotherapy fails to eradicate all affected lymph nodes. However, surgery has not traditionally been considered a viable stand-alone treatment for early metastatic seminoma.

The national study enrolled 55 patients across 12 institutions.

Most patients were able to go home 24 hours after surgery with minimal or no complications, according to Daneshmand.

Daneshmand and his colleagues found that 81% of the patients demonstrated a two-year recurrence-free survival rate. The 20% who did experience recurrence of the cancer were successfully treated with either chemotherapy or additional surgery for an overall survival rate of 100%.

"A 100% survival suggests that a cure can still be achieved even in patients who experience recurrence after the surgery," said Daneshmand.

[ConservativeMind]

No chemo, radiation, or immunotherapy was needed for 81%, meaning only 19% were in need of it, two years later, and all were cured.

[ConservativeMind]

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[algore]

I had mine replaced a long time ago

[ConservativeMind]

I think everyone would rather be cancer free.