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Stage IIB Seminoma — SCE Medical Oncology MCQ

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ModerateUrological CancersStage IIB SeminomaSCE Medical Oncology

A 40-year-old man with stage II seminoma and a 4.5 cm retroperitoneal lymph node mass (stage IIB) undergoes orchidectomy. AFP is normal. HCG is mildly elevated. What is the standard treatment?

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Correct answer: A — Cisplatin-based chemotherapy (BEP × 3 or EP × 4)

For stage IIB seminoma (retroperitoneal nodes 2-5 cm), either radiotherapy or chemotherapy can be used, but chemotherapy (BEP × 3 or EP × 4) is increasingly preferred for IIB due to: (1) lower relapse rates (~5% vs ~15% with RT), (2) avoidance of radiation-associated late effects, and (3) higher cure rates. For IIA (<2 cm nodes), radiotherapy and chemotherapy are considered equivalent. For IIC (>5 cm), chemotherapy is the clear standard.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/cancer