Premium
Pelvic recurrence in stage I seminoma: A new phenomenon that questions modern protocols for radiotherapy and follow‐up
Author(s) -
POWER RICHARD E,
KENNEDY JOHN,
CROWN JOHN,
FRASER IAN,
THORNHILL JOHN A
Publication year - 2005
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.1442-2042.2005.01114.x
Subject(s) - medicine , seminoma , radiation therapy , pelvis , stage (stratigraphy) , adjuvant radiotherapy , surgery , incidence (geometry) , radiology , chemotherapy , physics , optics , paleontology , biology
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.