Romanian Society of Pharmaceutical Sciences
 

« Back to Farmacia Journal 4/2026

LYMPHOVASCULAR INVASION AS A CRITERION FOR SELECTING ADJUVANT CHEMOTHERAPY VERSUS SURVEILLANCE IN TESTICULAR SEMINOMA

EMANUELA FLORENTINA ROHOZNEANU 1,2*, CIPRIAN DEAC 2, OVIDIU CRIȘAN 3, CĂLIN IOAN CĂINAP 1,²

¹ Department of Oncology, The Oncology Institute “Prof. Dr. Ion Chiricută” Cluj-Napoca, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400015, Cluj-Napoca, Romania
2 Department of Oncology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012, Cluj-Napoca, Romania
3 Discipline of Organic Chemistry, Faculty of Pharmacy, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400012, Cluj-Napoca, Romania

Download Full Article PDF

Testicular seminoma generally has an excellent prognosis, but relapse may occur, highlighting the need for reliable risk stratification factors to guide the choice between adjuvant carboplatin and active surveillance after orchiectomy. This retrospective single-center study evaluated the prognostic role of lymphovascular invasion (LVI) in 60 patients with testicular seminoma treated at the Oncology Institute “Prof. Dr. Ion Chiricuță” in Cluj-Napoca between 2016 and 2021. LVI was defined by lymphatic and/or vascular invasion on histopathology, and associations with stage, progression-free survival (PFS), and overall survival (OS) were assessed. Median age was 37 years; 36 patients had stage I disease, 14 stage II, and 10 stage III. LVI was present in 37 patients and was significantly associated with advanced stage at diagnosis (Fisher's exact test, p = 0.0066; OR = 5.43, 95% CI: 1.42–26.27). However, LVI was not significantly associated with PFS in stage I disease. The estimated 5-year PFS was 88.2% in LVI-positive patients and 89.5% in LVI-negative patients. Similar findings were observed in the overall cohort, with estimated 5-year PFS of 81.1% versus 91.3%, respectively. OS differed significantly by stage, with worse survival in stage III disease. Among stage I patients, recurrence occurred in 20.0% of those under surveillance and 9.5% of those receiving adjuvant carboplatin, without a statistically significant difference. These findings suggest that LVI may reflect higher disease burden at diagnosis, but its independent prognostic value in seminoma remains uncertain, and it does not currently justify LVI-based selection for adjuvant carboplatin, given the drug's potential for acute and long-term toxicity.