Surveillance after orchidectomy for patients with clinical stage I nonseminomatous testis tumors.

Abstract

Surveillance is a valid alternative to immediate retroperitoneal lymph node dissection in patients with clinical stage I NSGCTT but should be recommended only under the close supervision of physicians experienced in the diagnosis and treatment of testicular cancer.

Canadian consensus guidelines for the management of testicular germ cell cancer

“…[39][40][41][42][43][44][45][46][47][48] A total of 1768 patients were evaluated and with a median follow-up range of 19.5 to 76 months, 378 recurrences were reported (21.4%). Across the studies, 13 deaths from testicular cancer were reported, along with 7 other deaths.…”

Current Concepts in Management of Stage I NSGCT

“…Presence of embryonal cell carcinoma, absence of endodermal sinus tumour and invasion of tumour cells into blood and lymphatic vessels have been found to be predictors of relapse [1,12,13]. Subsequent studies have shown that vascular invasion (VI) is the single most important prognostic factor regarding risk of relapse [14][15][16][17]. Without adjuvant treatment, the high-risk group (VI positive) has a 3-year relapse rate of approximately 50%, while low-risk patients (VI negative) have a relapse risk of 10 to 20% [1,3,[16][17][18][19][20][21][22].…”

Management of patients with clinical stage I nonseminomatous germ cell testicular cancer: Active surveillance versus adjuvant chemotherapy – single-centre experience

“…Preliminary results were enthusiastic [2,3,4], but critical voices arose against general use of this option as a routine management [5]. With longer observation, the relapse rate increased up to 25 % or more after orchiectomy [6,7]. Several studies [5,7,8,9] identified statistically significant predictors of relapse in CSI NSGCTT patients who might therefore benefit from a program other than surveillance.…”

“…With longer observation, the relapse rate increased up to 25 % or more after orchiectomy [6,7]. Several studies [5,7,8,9] identified statistically significant predictors of relapse in CSI NSGCTT patients who might therefore benefit from a program other than surveillance. Vascular invasion of the primary tumor was the most consistent prognostic feature identified.…”