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Surveillance Study for Clinical Stage I Testicular Seminomas and Nonseminomatous Germ Cell Tumors
Author(s) -
Suzuki Kenichi,
Orikasa Seiichi,
Hoshi Senji,
Yoshikawa Kazuyuki,
Imai Yoshitada,
Aizawa Masataka,
Nishimura Yousuke,
Okada Yasuhiro,
Ohnuma Tetsutaro,
Ogata Yukihiko
Publication year - 1998
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/j.1442-2042.1998.tb00414.x
Subject(s) - medicine , seminoma , orchiectomy , testicular cancer , stage (stratigraphy) , germ cell tumors , chemotherapy , surgery , lung , radiology , urology , paleontology , biology
Background: Optimal therapy for stage I testicular tumors is still controversial. This study evaluated the efficacy of a surveillance policy for patients with testicular stage I seminomas and nonseminomatous germ cell tumors (NSGCT). Methods: From 1984 to 1996, 24 patients with stage I semi noma and 20 with stage I NSGCT were fol lowed after radical orchiectomy with tumor markers and imaging studies. All patients were followed for at least 2 years except for those who recurred within 2 years. Recurrent patients were treated with cisplatin‐based chemotherapy. Results: The median follow‐up periods for seminoma and NSGCT patients were 41 and 54 months, respectively. Recurrences were detected in 2 seminoma (8.3%) and 10 NSGCT (50%) patients. Eleven of the 1 2 recurrent patients (92%) were detected within 2 years after orchiectomy. The seminoma patients both recurred in the retroperitoneal lymph nodes, while 70% of the NSGCT patients recurred in the lung and/or retroperitoneal lymph nodes. The recurrent seminoma patients were treated with chemotherapy and are alive without disease for 1 7 and 24 months after orchiectomy. One NSGCT patient died of cancer, but the other 9 recurrent NSGCT patients are alive without disease at 25 to 11 3 months after orchiectomy. Conclusions: Surveillance alone is reliable for monitoring patients with stage I testicular seminoma and NSGCT. The majority of recurrences occurred within 2 years, necessitating intensive follow‐up for 3 years. As the lung metastatic rates in NSGCT patients were high, a more accurate assessment for lung metastasis is desirable in these patients.