A surveillance study of clinical stage I nonseminomatous germ cell tumors of the testis: 10-year followup.
OBJECTIVE
We evaluate the 10-year results of a surveillance study of clinical stage I nonseminomatous germ cell tumors of the testis.


METHODS
Between 1981 and 1984 we recruited 85 consecutive evaluable patients with nonseminomatous germ cell tumors of the testis and normal post-orchiectomy physical examination, chest x-rays, bipedal lymphangiography, abdominal scans and serum tumor markers. The patients were followed for at least 10 years after orchiectomy alone, which was performed elsewhere in 90% of the cases.


RESULTS
The interval between visits was twice as long as it was scheduled. Relapses occurred in 25 patients (29.4%) after a median disease-free interval of 7 months (range 2 to 68). Five patients had further relapses and 3 (3.5%) died of cancer. Retroperitoneal relapses (19%) occurred later than lung relapses, and they were diagnosed when larger than 5 cm. in 7 patients. The percentage of embryonal carcinoma within the tumor associated with relapse (p = 0.008), T category (p = 0.023), scrotal violation (p = 0.042) and vascular invasion (p = 0.063) had a weak correlation but data on T category and vascular invasion were available for only some patients.


CONCLUSIONS
Surveillance is a difficult type of study and missing data may compromise the therapeutic program based on prognostic factors.
Nicolai
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Division of Urology, Istituto Nazionale Tumori, Milan, Italy.
Pizzocaro
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D005500:Follow-Up Studies; D018237:Germinoma / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008175:Lung Neoplasms / Q000556:secondary; D008297:Male; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D009919:Orchiectomy; D012186:Retroperitoneal Neoplasms / Q000556:secondary; D013736:Testicular Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery