Open Access

ARTICLE

Surveillance in stage I testicular seminoma risk of late relapse

P. Chung¹, C. Parker¹, T. Panzarella², M. K. Gospodarowicz¹, M.A. S. Jewett³, M. F. Milosevic¹, C. N. Catton¹, A. J. Bayley¹, B. Tew-George, M. Moore⁴, J. F. G. Sturgeon⁴, P. Warde¹

1 Department of Radiation Oncology, Princess Margaret Hospital, Toronto, Ontario, Canada
2 Department of Biostatistics, Princess Margaret Hospital, Toronto, Ontario, Canada
3 Division of Urology, Department of Surgery, Toronto General Hospital, Toronto, Ontario, Canada
4 Department of Medical Oncology, Princess Margaret Hospital, Toronto, Ontario, Canada
Address correspondence to Dr. P. Warde, Princess Margaret Hospital, 610 University Avenue, Toronto, Ontario MSG 2M9 Canada

Canadian Journal of Urology 2002, 9(5), 1637-1640.

Abstract

Introduction: Surveillance is an alternative to adjuvant radiotherapy for stage I testicular seminoma. We present the long-term results of seminoma surveillance, with emphasis on quantifying the risk of late relapse beyond 5 years.
Methods: From 1981 to 1993, of 431 men with stage I testicular seminoma, 203 were managed by surveillance following radical orchidectomy. The surveillance protocol comprised a combination of clinical examination, CT scans of abdomen and pelvis, chest x-rays and serum markers, at defined intervals.
Results: At a median follow-up of 9.2 years, 35 men have relapsed. Five of the relapses occurred more than 5 years after orchidectomy (at 5.1, 6.9, 7.3, 7.3, and 9.0 years). The actuarial risk of relapse at 5 and 10 years was 15% (standard error [SE] 1.1%) and 18% (SE 1.8%) respectively. One hundred sixty one men were free of relapse at 5 years, and have been followed beyond this point for a median of 4.3 years. The actuarial risk of relapse between 5 and 10 years was 4% (SE 0.5%).
Conclusions: These results demonstrate that there is a small but clinically significant risk of relapse more than 5 years after orchidectomy for stage I seminoma. These data support the need for long term surveillance.

---

Keywords

---