Stage I seminoma of the testis: Is post-orchidectomy surveillance a safe alternative to routine postoperative radiotherapy?

Ramakrishnan, S.; Champion, A.E.; Dorreen, M.; M, Fox

doi:10.1016/s0936-6555(05)81100-8

Cited by 39 publications

(7 citation statements)

References 10 publications

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“…Several institutions have introduced a surveillance policy for stage I patients with GCTs [23–27] stating that, despite the outcome not being compromised when surveillance is used instead of routine adjuvant radiation therapy, further follow‐up may be necessary because of late relapses. A surveillance policy demands extensive resources and requires long‐term patient compliance.…”

Section: Discussionmentioning

confidence: 99%

Stage I seminoma of the testis: a bi‐institutional retrospective analysis of patients treated with radiation therapy only

et al. 2003

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interviews in men who no longer needed a long-term follow-up. RESULTSThe 10-year overall survival was 97% (98% and 96%, respectively, for the aortic nodes only, or aortic and iliac nodes, i.e. the 'dog leg' field) and disease-free survival was 94%. Twenty-one patients relapsed (five with a true 'in-field' recurrence, nine progressed to the mediastinum, and seven had disseminated disease). Acute toxicity was mainly gastrointestinal, with 7.6% classified as grade II. In all, 73 men achieved paternity after irradiation; nine did not but had normal sperm. Second malignancies were diagnosed in 16 (3.3%) men. CONCLUSIONPara-aortic irradiation may be used safely in patients with stage I seminoma and undisturbed testicular drainage, with equivalent results to the 'dog-leg' group; these unrandomized data confirm the lower toxicity and equivalent survival rates of this treatment.

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Section: Discussionmentioning

confidence: 99%

Stage I seminoma of the testis: a bi‐institutional retrospective analysis of patients treated with radiation therapy only

et al. 2003

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“…[13][14][15][16][17][18][19][20] The data in these series are now mature and relapse rates have consistently been reported to be about 15% in unselected patients with stage I disease. The predominant site of relapse in all studies was in the paraaortic lymph nodes; 41 of 49 (82%) of relapses in the Danish Testicular Cancer Study Group (DATECA) study and 57 of 64 (85%) in the Princess Margaret Hospital (PMH) series.…”

Section: Surveillancementioning

confidence: 99%

Canadian consensus guidelines for the management of testicular germ cell cancer

Wood

Kollmannsberger

Jewett

et al. 2013

CUAJ

123

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“…found that 5.4% of patients treated with radiation relapsed versus 18% of those on surveillance. 10 In a Danish surveillance study (261 patients), the 4-year relapse rate was 6% for tumors less than 3 cm, 18% for tumors 3-6 cm and 36% for tumors greater than 6 cm. 11 A recent meta-analysis of four studies (638 patients) identified potential risk factors for relapse on surveillance after orchidectomy.…”

Section: Discussionmentioning

confidence: 98%

Pelvic recurrence in stage I seminoma: A new phenomenon that questions modern protocols for radiotherapy and follow‐up

et al. 2005

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Objective : To highlight the increased risk for pelvic relapse in patients with stage 1 seminoma treated with adjuvant radiotherapy limited to para-aortic template alone. Patients and methods : Over a four-year period, three patients presented with early pelvic recurrence after radical orchidectomy and adjuvant irradiation for stage 1 seminoma. In each case, radiotherapy had been limited to the para-aortic region with omission of the ipsilateral hemi pelvis.Results : Pelvic recurrences occurred on the ipsilateral tumor side. Durable complete remission was achieved in each case; however, treatment was complex and there was associated morbidity. Conclusion : This significant incidence of pelvic recurrence questions the validity of modern radiotherapy protocol which excludes the ipsilateral pelvis from the radiation field.

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Stage I seminoma of the testis: Is post-orchidectomy surveillance a safe alternative to routine postoperative radiotherapy?

Cited by 39 publications

References 10 publications

Stage I seminoma of the testis: a bi‐institutional retrospective analysis of patients treated with radiation therapy only

Stage I seminoma of the testis: a bi‐institutional retrospective analysis of patients treated with radiation therapy only

Canadian consensus guidelines for the management of testicular germ cell cancer

Pelvic recurrence in stage I seminoma: A new phenomenon that questions modern protocols for radiotherapy and follow‐up

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