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Surveillance versus Adjuvant Treatment with Chemotherapy or Radiotherapy for Stage I Seminoma: A Systematic Review and Meta-Analysis According to EAU COVID-19 Recommendations.
Kang, Dong Hyuk; Cho, Kang Su; Jeong, Jae Yong; Moon, Young Joon; Chung, Doo Yong; Jung, Hae Do; Lee, Joo Yong.
  • Kang DH; Department of Urology, Inha University College of Medicine, Incheon 22212, Korea.
  • Cho KS; Department of Urology, Gangnam Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul 06273, Korea.
  • Jeong JY; Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul 03722, Korea.
  • Moon YJ; Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul 03722, Korea.
  • Chung DY; Department of Urology, Inha University College of Medicine, Incheon 22212, Korea.
  • Jung HD; Department of Urology, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang 10380, Korea.
  • Lee JY; Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul 03722, Korea.
Medicina (Kaunas) ; 58(11)2022 Oct 24.
Article in English | MEDLINE | ID: covidwho-2082036
ABSTRACT
Background and

Objectives:

During the coronavirus disease 2019 (COVID-19) outbreak, the European Association of Urology (EAU) Guidelines Office Rapid Reaction Group (GORRG) recommended that patients with clinical stage I (CSI) seminoma be offered active surveillance (AS). This meta-analysis aimed to evaluate the efficacy of AS versus adjuvant treatment with chemotherapy or radiotherapy for improving the overall survival (OS) of CSI seminoma patients. Materials and

Methods:

A systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The PubMed/Medline, EMBASE, and Cochrane Library databases were searched. The primary outcome was 5-year OS, and the secondary outcome was the 5-year relapse-free survival (RFS). The outcomes were analyzed as odds ratios (ORs) and 95% confidence intervals (CIs).

Results:

A total of 14 studies were included. Overall, the quality scores were relatively high, and little publication bias was noted. In terms of the 5-year OS, 7 studies were analyzed; there was no significant difference between AS and adjuvant treatment (OR, 0.99; 95% CI, 0.41-2.39; p = 0.97). In terms of 5-year RFS, 12 studies were analyzed. Adjuvant treatment reduced the risk of 5-year recurrence by 85% compared with AS (OR, 0.15; 95% CI, 0.08-0.26; p < 0.001).

Conclusions:

In terms of the OS in CSI seminoma patients, no intergroup difference was noted, so it is reasonable to offer AS, as recommended by the EAU GORRG until the end of the COVID-19 pandemic. However, since there is a large intergroup difference in the recurrence rate, further research on the long-term (>5 years) outcomes is warranted.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Testicular Neoplasms / Urology / Seminoma / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Reviews / Systematic review/Meta Analysis Limits: Humans / Male Language: English Journal subject: Medicine Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Testicular Neoplasms / Urology / Seminoma / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Reviews / Systematic review/Meta Analysis Limits: Humans / Male Language: English Journal subject: Medicine Year: 2022 Document Type: Article