nsRPLND Appears Safe, Effective in Low-Volume Metastatic Seminoma

Nerve-sparing retroperitoneal lymph node dissection (nsRPLND) appears safe and effective for patients with low-volume metastatic seminoma, results of the phase 2 COTRIMS trial suggest.

These results were presented at the 2023 ASCO Genitourinary Cancers Symposium by Tim Nestler, MD, of the University Hospital of Cologne in Germany. 

Dr Nestler reported outcomes in 30 patients with pure testicular seminoma who underwent nsRPLND. The patients’ mean age was 34.2 (range, 21-65) years. At nsRPLND, patients had clinical stage IIA (63.3%) or IIB (36.4%) disease.

Most patients (n=27) underwent open nsRPLND, and 3 underwent robot-assisted nsRPLND. Antegrade ejaculation was preserved in 26 patients, and 4 patients had grade 3a-4 complications.

The mean number of resected lymph nodes was 17.1 (range, 8-56), the mean number of positive lymph nodes was 1.4 (range, 1-2), and the mean size of positive nodes was 2.1 cm (range, 1.0-4.5 cm).

Most patients (n=26) had seminoma, but 3 patients had benign disease, and 1 had embryonal carcinoma. Eighteen patients underwent serum analysis of miR371, yielding a sensitivity of 93.3% and a specificity of 100%.

At a mean follow-up of 29.4 months, the overall survival rate was 100%, and the intervention-free survival rate was 86.7%. Three patients relapsed at 4 months, 6 months, and 9 months, respectively.

Based on these results, Dr Nestler concluded that nsRPLND appears to have “high oncological efficacy with low surgical-related complications and minimal long-term toxicity” for patients with clinical stage IIA/B seminomas. 

Disclosures: Dr Nestler disclosed receiving honoraria from Janssen. One study author declared affiliations with several biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

Reference

Heidenreich A, Seelemeyer F, Paffenholz P, Pfister DA. Interim analysis of the prospective COTRIMS (Cologne Trial of Retroperitoneal Lymphadectomy in Metastatic Seminoma) trial. ASCO GU 2023. February 16-18, 2023. Abstract 409.

This article originally appeared on Cancer Therapy Advisor