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Stage I Seminoma of the Testis. Adjuvant Radiotherapy or Surveillance?
Author(s) -
ALLHOFF E. P.,
LIEDKE SUSANNE,
RIESE W.,
STIEF C.,
SCHNEIDER B.
Publication year - 1991
Publication title -
british journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 0007-1331
DOI - 10.1111/j.1464-410x.1991.tb15293.x
Subject(s) - seminoma , medicine , radiation therapy , orchiectomy , occult , stage (stratigraphy) , chemotherapy , oncology , urology , surgery , pathology , paleontology , alternative medicine , biology
Summary— Lately the role of radiotherapy in stage I seminoma of the testis has been questioned by some authors who reported on a “surveillance” strategy for these patients. Since 1980, 124 patients with seminoma of the testis have been referred to this institution; 97 of 116 patients analysed presented with stage I disease and 10 of these had elevated levels of βHCG. A total of 64 patients were given radiotherapy after orchiectomy and 33 entered a surveillance protocol. After a median follow‐up of 48 months, 3 patients in the surveillance group relapsed after 5, 13 and 49 months and 2 of the irradiated patients did so after 25 and 33 months. Elevation of βHCG was not significant because none of these patients showed progression. A low rate of progression and excellent survival are associated with standard treatment (orchiectomy and radiotherapy) and good results have been achieved with chemotherapy in cases of relapse. A surveillance policy is not recommended in stage I seminoma because of its slower growth compared with non‐seminomatous germ cell tumours (NSGCT), the absence of a specific tumour marker, the 10% risk of occult metastases and the 3‐fold higher progression rate compared with irradiated patients. We suggest the use of a reduced dosage and radiation field.