How would you approach a patient with good-risk stage III pure seminoma who has an excellent response to first-line chemotherapy, including normalization of tumor markers and resolution of measurable disease, but has a persistent pleural effusion with cytology showing rare malignant cells consistent with seminoma?
Would persistent cytology-positive pleural fluid after otherwise successful first-line therapy be considered evidence of refractory disease warranting second-line systemic therapy, or would you pursue additional evaluation or observation before escalating treatment?
1 Answer
Mednet MemberInvited Expert
Medical Oncology · Testicular Cancer Commons
Answered on
This is not a pattern or behavior of seminoma that I have seen. My first thought is that I would probably not do anything but observe him at this point. I am concerned that the cytology finding is not accurate. There is no penalty for waiting. If he has persistent disease, he will declare that soon ...
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