Outcome Of Patients With Stage 2 Or Stage 3 Seminoma Treated With 3 Cycles Of Cisplatin-Etoposide Chemotherapy (Ep120): Updated Data From A Single Center Retrospective Study.

e16061 Background: Metastatic seminoma is eminently treatable with platinum-based chemotherapy with either 3 cycles of BEP—bleomycin (B), etoposide (E) and cisplatin (P)—or 4 cycles of EP, achieving remission in more than 95% of the patients. However, bleomycin has a substantial toxicity profile and can cause life-threatening lung toxicity. Whether similar cure rates can be achieved without exposing patients to bleomycin is still undetermined. We describe our 19-year experience of treating patients with stage 2 or stage 3 seminoma with 3 cycles of EP chemotherapy. Methods: Patients who received 3 cycles of EP120 chemotherapy (50mg/m2 cisplatin day 1 and 2 and 120mg/m2 etoposide days 1, 2 and 3 every 3 weeks for 3 cycles) for stage 2 or stage 3 seminoma between 01/03/2000 and 31/05/2015 were identified. Data were retrospectively collected on stage, prognostic group, previous adjuvant treatment, serological and radiological response, time to relapse and subsequent management, progression-free survival (PFS) and overall survival (OS). Results: We identified 115 patients who received EP120 for seminoma and who met the inclusion criteria. Median age was 40 years (range 17-72). All patients were in the good-prognosis group. 103 patients (90%) were diagnosed with stage 2 seminoma, 12 patients (10%) with stage 3 (3 patients stage 3a and 9 stage 3b). 97 patients (84%) presented with stage 2 or 3 seminoma and 18 patients (16%) had progressed to stage 2 or 3 following adjuvant radiotherapy or adjuvant carboplatin chemotherapy for stage 1 disease. Seven patients (6%) with stage 2 seminoma relapsed after EP120 chemotherapy: 2 patients ≤3 months and 5 patients ≥ 3 months. None of the patients with stage 3 disease has relapsed so far. Of the 7 patients who relapsed, 2 received radiotherapy, 4 received TIP (paclitaxel, ifosfamide, cisplatin) chemotherapy and 1 received a combination of TIP chemotherapy and radiotherapy. All patients who relapsed after EP120 are currently in remission. Two of the 115 patients (1.7%) died whilst in remission and of unrelated causes. The 5-year PFS was 94% and the OS was 98%. Conclusions: Our data suggest that patients treated with 3 cycles of EP120 had survival rates similar to patients treated with more aggressive chemotherapy regimens.