TREATMENT OF ADVANCED SEMINOMA - AN UPDATE

In this update, the recent developments in the treatment of patients w ith advanced seminoma are reviewed. Also, the approach for patients wi th residual disease after chemotherapy is described. It is concluded t hat the combination of etoposide and cisplatin seems to be the standar d treatment for patients with advanced seminoma, showing a durable res ponse in about 90% of the patients. Although the combination of etopos ide and carboplatin is less effective, newer carboplatin-based combina tions seem to have a comparable efficacy. Residual disease after chemo therapy can be safely observed if the diameter is less than 3 cm; howe ver, residuals larger than 3 cm frequently show a vital tumor and surg ical evaluation should therefore be considered.