The management of testicular cancer in Victoria, 1988-1993. Urology Study Committee of the Victorian Co-operative Oncology Group.
OBJECTIVE
To evaluate the patterns of care and management of testicular cancer in Victoria.


METHODS
Retrospective analysis of all cases of testicular cancer in Victoria from 1988 to 1993 identified through the Victorian Cancer Registry.


METHODS
Description of patient characteristics, staging investigations, initial management, and outcome.


RESULTS
667 eligible cases of testicular cancer were identified and questionnaires were returned for 633 of these patients (94.9% response rate). There were 357 (56.4%) patients with pure seminoma; 271 (42.8%) with non-seminomatous germ cell tumours, 3 (0.5%) with stromal tumours, and 2 (0.3%) with other tumours. The median age was 32 years (range, 0-80 years). Preoperative marker levels were not available for 8% of patients, and initial staging was considered inadequate in 6%. Surveillance programs used for patients with Stage I disease were considered inadequate in most. Relative survival at five years was 99% for patients with seminoma and 91% for non-seminoma.


CONCLUSIONS
There was considerable variation in the investigation, treatment, and follow-up of these patients, which is likely to have resulted in unnecessary morbidity. Clinical practice guidelines should be developed and implemented to promote optimal management.
Toner
G C
GC
Medical Oncology, Peter MacCallum Cancer Institute, Melbourne, VIC. gtoner@petermac.unimelb.edu.au
Neerhut
G J
GJ
Schwarz
M A
MA
Thursfield
V J
VJ
Sandeman
T F
TF
Giles
G G
GG
Snow
R M
RM
D000293:Adolescent; D000328:Adult; D000359:Aftercare; D000368:Aged; D000369:Aged, 80 and over; D019468:Disease Management; D018237:Germinoma / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D006801:Humans; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D010818:Practice Patterns, Physicians'; D016016:Proportional Hazards Models; D011787:Quality of Health Care; D012189:Retrospective Studies; D018239:Seminoma / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D015996:Survival Rate; D013736:Testicular Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D014739:Victoria / Q000453:epidemiology