2018Urology PracticeRequires access

Retroperitoneal Lymph Node Dissection as an Alternative Treatment Strategy for Low Volume, Clinical Stage II Testicular Seminoma: A Survey of Patients and Providers

Jason Warncke, Amanda F. Saltzman, Paul Maroni, Siamak Daneshmand, Nicholas G. Cost

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Abstract

INTRODUCTION: Retroperitoneal lymph node dissection for low volume, clinical stage II testicular seminoma may provide an alternative to radiation therapy or chemotherapy for local control, preserving the high rate of cure while reducing exposure to long-term side effects. In this study we determined the willingness of patients and providers to participate in a clinical trial with this approach. METHODS: We distributed 2 surveys, with one going to patients with testicular seminoma and one to providers who treat testicular cancer. This study included patients with pure seminoma and providers currently in clinical practice. Logistic regression analysis was performed to identify factors associated with willingness to participate in the proposed trial. RESULTS: Overall 193 patients with testicular seminoma and 178 actively practicing providers responded to the surveys. Of these respondents 148 patients (76.7%) and 167 providers (81.9%) reported that they would be willing to participate in the proposed clinical trial. For patients, on univariate analysis age, stage, management after orchiectomy and relapse status did not impact willingness to enroll. For providers, on univariate analysis years in practice, number of patients with testicular cancer evaluated annually, practice setting and association with a Comprehensive Cancer Center did not impact willingness to offer enrollment. CONCLUSIONS: The majority of patients and providers would be willing to participate in a trial of retroperitoneal lymph node dissection as an alternative treatment strategy for low volume, clinical stage II testicular seminoma.

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INTRODUCTION: Retroperitoneal lymph node dissection for low volume, clinical stage II testicular seminoma may provide an alternative to radiation therapy or chemotherapy for local control, preserving the high rate of cure while reducing exposure to long-term side effects. In this study we determined the willingness of patients and providers to participate in a clinical trial with this approach. METHODS: We distributed 2 surveys, with one going to patients with testicular seminoma and one to providers who treat testicular cancer. This study included patients with pure seminoma and providers currently in clinical practice. Logistic regression analysis was performed to identify factors associated with willingness to participate in the proposed trial. RESULTS: Overall 193 patients with testicular seminoma and 178 actively practicing providers responded to the surveys. Of these respondents 148 patients (76.7%) and 167 providers (81.9%) reported that they would be willing to participate in the proposed clinical trial. For patients, on univariate analysis age, stage, management after orchiectomy and relapse status did not impact willingness to enroll. For providers, on univariate analysis years in practice, number of patients with testicular cancer evaluated annually, practice setting and association with a Comprehensive Cancer Center did not impact willingness to offer enrollment. CONCLUSIONS: The majority of patients and providers would be willing to participate in a trial of retroperitoneal lymph node dissection as an alternative treatment strategy for low volume, clinical stage II testicular seminoma.

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Available abstract

INTRODUCTION: Retroperitoneal lymph node dissection for low volume, clinical stage II testicular seminoma may provide an alternative to radiation therapy or chemotherapy for local control, preserving the high rate of cure while reducing exposure to long-term side effects. In this study we determined the willingness of patients and providers to participate in a clinical trial with this approach. METHODS: We distributed 2 surveys, with one going to patients with testicular seminoma and one to providers who treat testicular cancer. This study included patients with pure seminoma and providers currently in clinical practice. Logistic regression analysis was performed to identify factors associated with willingness to participate in the proposed trial. RESULTS: Overall 193 patients with testicular seminoma and 178 actively practicing providers responded to the surveys. Of these respondents 148 patients (76.7%) and 167 providers (81.9%) reported that they would be willing to participate in the proposed clinical trial. For patients, on univariate analysis age, stage, management after orchiectomy and relapse status did not impact willingness to enroll. For providers, on univariate analysis years in practice, number of patients with testicular cancer evaluated annually, practice setting and association with a Comprehensive Cancer Center did not impact willingness to offer enrollment. CONCLUSIONS: The majority of patients and providers would be willing to participate in a trial of retroperitoneal lymph node dissection as an alternative treatment strategy for low volume, clinical stage II testicular seminoma.

Key concepts: Medicine, Seminoma, Testicular cancer, Retroperitoneal lymph node dissection, Dissection (medical), Lymph node, Stage (stratigraphy), Univariate analysis

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Retroperitoneal Lymph Node Dissection as an Alternative Treatment Strategy for Low Volume, Clinical Stage II Testicular Seminoma: A Survey of Patients and Providers — Research Paper | ScholarLens