A Nationwide Cohort Study of Stage I Seminoma Patients Followed on a Surveillance Program

Recommendations for followup of stage I and II seminoma: The Princess Margaret Cancer Centre approach

“…43 The pooled multi-institutional data reported an elevated HCG in 3% of relapses, 16 and a large Danish surveillance program described isolated elevated STMs in less than 1% of relapses. 9 In our series, abnormal STM levels were noted in 14% of relapsed cases during surveillance, but none in isolation with all patients having radiological evidence of relapsed disease. 23,44 Although STMs are a minimally invasive investigation, given its low yield of detecting relapse when routine imaging is performed during followup, at our institution we no longer routinely measure STMs during followup of stage I seminoma.…”

“…9,15,23,32 At the Princess Margaret Cancer Centre, 23 similar to the Danish cohort study, 9 retroperitoneal metastases either in isolation or with synchronous pelvic or inguinal metastases, accounted for 93% of relapses. Abdominopelvic CT is the main method of detecting infradiaphragmatic relapses in 85 -99% of surveillance cases.…”

“…Relapse during surveillance for stage I seminoma occurs most frequently within the first 3 years. 9,16,23,38 Pooled data from 5 institutions found that in more than 1300 patients, 92% of recurrences were observed within 3 years. 16 The systematic review by Martin et al…”

“…Abdominopelvic CT is the main method of detecting infradiaphragmatic relapses in 85 -99% of surveillance cases. 9,16,23 CUAJ -Review…”

“…1 Early stage (stage I and IIA/B) testicular seminoma has 5-year overall and disease-specific survival rates that exceed 90% and 95%, respectively. [2][3][4][5][6][7][8][9] Published guidelines for testicular seminoma provide consistent treatment recommendations, but followup schedules vary. [10][11][12][13][14] The aim of followup after cancer treatment is to detect and manage relapse, but monitoring and treating toxicity from therapy is also necessary.…”