Retroperitoneal Lymph Node Dissection in Treating Patients With Testicular Seminoma
Surgery in Early Metastatic Seminoma (SEMS): Phase II Trial of Retroperitoneal Lymph Node Dissection as First-Line Treatment for Testicular Seminoma With Isolated Retroperitoneal Disease (1-3cm)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
PRIMARY OBJECTIVES:
I. Assess the recurrence free survival (RFS) at 2 years after RPLND when RPLND is used as a first line treatment for patients with testicular seminoma and low volume (=< 2cm) retroperitoneal disease.
SECONDARY OBJECTIVES:
I. Estimate the percent of patients, after treatment with RPLND, who can avoid external beam radiotherapy (XRT) or systemic chemotherapy (CTX) for seminoma.
II. Assess the complications associated with primary RPLND for seminoma.
OUTLINE:
Patients undergo RPLND.
After completion of study treatment, patients are followed up at 1 month, every 4 months for 1 year, every 6 months for 2 years, and then annually thereafter.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
California
-
Loma Linda, California, United States, 92350
- Loma Linda University Medical Center
-
Los Angeles, California, United States, 90033
- USC / Norris Comprehensive Cancer Center
-
San Francisco, California, United States, 94143
- University of California, San Francisco
-
Stanford, California, United States, 94305
- Stanford University Hospitals & Clinics
-
-
Colorado
-
Aurora, Colorado, United States, 80045
- University of Colorado Hospital - Aurora
-
-
Georgia
-
Atlanta, Georgia, United States, 30322
- Emory University
-
-
Illinois
-
Chicago, Illinois, United States, 60637
- University of Chicago Medical Center
-
-
Indiana
-
Indianapolis, Indiana, United States, 46202
- Indiana University
-
-
Maryland
-
Baltimore, Maryland, United States, 21205
- Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
-
-
Minnesota
-
Rochester, Minnesota, United States, 55905
- Mayo Clinic
-
-
New Jersey
-
New Brunswick, New Jersey, United States, 08903-2681
- Rutgers Cancer Institute of New Jersey
-
-
Oklahoma
-
Oklahoma City, Oklahoma, United States, 73104
- Stephenson Cancer Center, University of Oklahoma
-
-
Texas
-
Dallas, Texas, United States, 75390-9110
- UTSouthwestern Medical Center
-
-
Washington
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Tacoma, Washington, United States, 98431
- Madigan Army Medical Center
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Pure seminoma after orchiectomy presenting with isolated retropreritoneal lymphadenopathy OR stage I pure seminoma with isolated retroperitoneal relapse. Relapse should be within 3 years
Lymphadenopathy in the retroperitoneum: at least one lymph node 1-3 cm in greatest dimension, no lymph node > 3 cm in greatest dimension, no more than 2 lymph nodes 1-3 cm in greatest dimension
- Axial imaging of lymphadenopathy within 6 weeks of the date of RPLND
- Retroperitoneal lymphadenopathy must be within the RPLND template
- If there is borderline lymphadenopathy, defined as the largest retroperitoneal lymph node measuring 0.90 - 0.99 cm in the greatest dimension, an abdominal computed tomography (CT) scan should be repeated (recommend interval of 6 - 8 weeks); the same lymph node must demonstrate growth to >= 1.0 cm in the greatest dimension
- Biopsy is not required, though if biopsy of the retroperitoneal node(s) was obtained, pathology must be consistent with pure seminoma
- Chest imaging (x-ray, CT or magnetic resonance imaging [MRI]) negative for metastasis no more than 6 weeks prior to the date of RPLND
- Primary tumor excised by radical inguinal orchiectomy and pathology consistent with pure seminoma
- Serum alpha fetoprotein (AFP) not more than 1.5 times upper limit of normal, beta-human chorionic gonadotropin (HCG), lactate dehydrogenase (LDH) (per the local laboratory assay) within 14 days of RPLND
- Eastern Cooperative Oncology Group (ECOG) performance status =< 1
- Ability to understand and the willingness to sign a written informed consent
- Serum coagulation studies (INR/PTT) and platelet counts suitable for surgery per surgeon discretion.
Exclusion Criteria:
- Second primary malignancy
- History of receiving chemotherapy or radiotherapy
- Patients receiving any other investigational agent (s)
- Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Treatment (RPLND)
Patients undergo RPLND.
|
Correlative studies
Undergo RPLND
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
RFS
Time Frame: From RPLND to the time of recurrence or death, whichever comes first., assessed at 2 years after RPLND
|
Associated 95% confidence intervals will be constructed.
Actuarial RFS will be calculated by the Kaplan Meier method.
The recurrence location (pelvic, retroperitoneal, distant) will be calculated as a percentage of total recurrences to describe the clinical pattern of disease after relapse.
|
From RPLND to the time of recurrence or death, whichever comes first., assessed at 2 years after RPLND
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Long-term RPLND complication rates
Time Frame: Up to 5 years
|
The rate of short and long term complications will be calculated.
|
Up to 5 years
|
|
RFS
Time Frame: From RPLND to the time of recurrence or death, whichever comes first., assessed at 5 years after RPLND
|
Associated 95% confidence intervals will be constructed.
Actuarial RFS will be calculated by the Kaplan Meier method.
|
From RPLND to the time of recurrence or death, whichever comes first., assessed at 5 years after RPLND
|
|
Short-term RPLND complication rates
Time Frame: Up to 12 months
|
The rate of short and long term complications will be calculated.
|
Up to 12 months
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Siamak Daneshmand, University of Southern California
Publications and helpful links
General Publications
- Hu B, Alsyouf M, Farkouh A, Cary C, Masterson T, Einhorn L, Adra N, Boorjian SA, Kollmannsberger C, Schuckman A, So A, Black PC, Bagrodia A, Skinner E, Alemozaffar M, Brand T, Eggener S, Pierorazio P, Stratton K, Nappi L, Nichols C, Daneshmand S. Accuracy of 18F-Fluorodeoxyglucose Positron Emission Tomography in Early Metastatic Testicular Seminoma: Analysis From the SEMS Trial. J Urol. 2025 Sep;214(3):272-279. doi: 10.1097/JU.0000000000004561. Epub 2025 Apr 9.
- Daneshmand S, Cary C, Masterson T, Einhorn L, Adra N, Boorjian SA, Kollmannsberger C, Schuckman A, So A, Black P, Bagrodia A, Skinner E, Alemozaffar M, Brand T, Eggener S, Pierorazio P, Stratton K, Nappi L, Nichols C, Luo C, Li M, Hu B. Surgery in Early Metastatic Seminoma: A Phase II Trial of Retroperitoneal Lymph Node Dissection for Testicular Seminoma With Limited Retroperitoneal Lymphadenopathy. J Clin Oncol. 2023 Jun 1;41(16):3009-3018. doi: 10.1200/JCO.22.00624. Epub 2023 Mar 13.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimated)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 4T-14-1 (Other Identifier: USC / Norris Comprehensive Cancer Center)
- P30CA014089 (U.S. NIH Grant/Contract)
- NCI-2015-01177 (Registry Identifier: CTRP (Clinical Trial Reporting Program))
- HS-15-00246
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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