How would you treat a patient with late relapsed metastatic seminoma with only large (>10cm) pulmonary metastases and LDH nine times the upper limit of normal?
In reviewing the data, LDH does not upstage to intermediate risk but those patients tend to do worse.
Would one treat this patient as intermediate risk, with 4 cycles of VIP (given poor baseline lung function) or would 4 cycles of EP suffice?
2 Answers
Mednet MemberInvited Expert
Medical Oncology · Veterans Administration Health Care Center
Answered on
From the description, it is not really clear whether this is late relapse after initial surveillance or radiotherapy, versus relapse after chemotherapy.
If the former, which is what I think you are presenting, this is a pretty unusual pattern of presentation after surveillance or radiotherapy, and...
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Mednet MemberInvited Expert
Medical Oncology · Indiana Univ Simon Cancer Center
Answered on
I agree with Dr. @Dr. First Last. I would re- emphasize the need for hCG and AFP and especially biopsy of the large lung mass. Anything is possible, but in my experience, if his abdominal CT is normal, close to zero possibility this type of presentation, early or late relapse, would be a pure semino...
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