Surveillance policy for Japanese patients with stage I testicular germ cell cancer in the multi-detector computed tomography era

Yuasa, Takeshi; Inoshita, Naoko; Tanaka, Hajime; Urakami, Shinji; Yamamoto, Shinya; Fujii, Yasuhisa; Masuda, Hitoshi; Fukui, Iwao; Ishikawa, Yuichi; Yonese, Junji

doi:10.1007/s10147-015-0828-1

Cited by 1 publication

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References 19 publications

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“…Yuasa et al [ 18 ] observed relapses in 14.2% of patients without risk factors after AS. In our group of CSI testicular seminoma patients managed by AS, the relapse rate was determined to be 11.9%.…”

Section: Discussionmentioning

confidence: 99%

Controversies in the management of clinical stage I testicular seminoma

Ondrušová

Balogova

Lehotská

et al. 2016

CEJU

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IntroductionFollowing orchiectomy patients with clinical stage I (CSI) testicular seminoma may be managed by active surveillance (AS) or adjuvant treatment (radiotherapy or chemotherapy). In view of the published data on long-term toxicity, mainly second malignant neoplasms (SMNs), adjuvant radiotherapy (ART) is currently no longer recommended as adjuvant therapy for these patients. The purpose of our recent study was to compare the impact of two selected treatment approaches – AS versus adjuvant chemotherapy (ACT) on survival in patients with CSI testicular seminoma.Material and methodsThe cross-sectional study analyzed a total of 106 patients collected at a single centre between 4/2008–8/2015, with CSI testicular seminoma, stratified into two groups according to risk-adapted therapeutic approaches.ResultsIn group A (low-risk), consisting of 84 patients, who underwent AS, relapse occurred in 10 (11.9%) patients after a mean follow-up of 13.8 months. In group B (high-risk), consisting of 22 patients, who were treated with ACT, relapse occurred in two (9.1%) patients after a mean follow-up of 13.8 months. Overall survival of patients in both groups was 100% with a mean follow-up of 25.3 months. The statistically significant difference in progression-free survival (PFS) between these two groups was not found.ConclusionsACT seems to be adequate treatment for patients with high-risk of relapse, as well as AS for those with low-risk of relapse. Despite its excellent prognosis, optimal management of CSI testicular seminoma remains controversial, with variations in expert opinion and international guidelines.

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Section: Discussionmentioning

confidence: 99%