title: Surveillance in stage I testicular seminoma - risk of late relapse.
abstract: BACKGROUND
  Surveillance is an alternative to adjuvant radiotherapy for stage I testicular seminoma. We present the long-term results of seminoma surveillance, with emphasis on quantifying the risk of late relapse beyond 5 years.
  
  
  METHODS
  From 1981 to 1993, of 431 men with stage I testicular seminoma, 203 were managed by surveillance following radical orchidectomy. The surveillance protocol comprised a combination of clinical examination, CT scans of abdomen and pelvis, chest x-rays and serum markers, at defined intervals.
  
  
  RESULTS
  At a median follow-up of 9.2 years, 35 men have relapsed. Five of the relapses occurred more than 5 years after orchidectomy (at 5.1, 6.9, 7.3, 7.3, and 9.0 years). The actuarial risk of relapse at 5 and 10 years was 15% (standard error [SE] 1.1%) and 18% (SE 1.8%) respectively. One hundred sixty one men were free of relapse at 5 years, and have been followed beyond this point for a median of 4.3 years. The actuarial risk of relapse between 5 and 10 years was 4% (SE 0.5%).
  
  
  CONCLUSIONS
  These results demonstrate that there is a small but clinically significant risk of relapse more than 5 years after orchidectomy for stage I seminoma. These data support the need for long term surveillance.
authors.affiliation: Department of Radiation Oncology, Princess Margaret Hospital, Toronto, Ontario, Canada.
authors.forename: P
authors.initials: P
authors.lastname: Chung
authors.forename: C
authors.initials: C
authors.lastname: Parker
authors.forename: T
authors.initials: T
authors.lastname: Panzarella
authors.forename: M K
authors.initials: MK
authors.lastname: Gospodarowicz
authors.forename: S
authors.initials: S
authors.lastname: Jewett
authors.forename: M F
authors.initials: MF
authors.lastname: Milosevic
authors.forename: C N
authors.initials: CN
authors.lastname: Catton
authors.forename: A J
authors.initials: AJ
authors.lastname: Bayley
authors.forename: B
authors.initials: B
authors.lastname: Tew-George
authors.forename: M
authors.initials: M
authors.lastname: Moore
authors.forename: J F G
authors.initials: JF
authors.lastname: Sturgeon
authors.forename: P
authors.initials: P
authors.lastname: Warde
mesh_terms: D000328:Adult; D002985:Clinical Protocols; D003131:Combined Modality Therapy; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D009919:Orchiectomy; D011159:Population Surveillance; D016879:Salvage Therapy; D018239:Seminoma / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy*; D016019:Survival Analysis; D013736:Testicular Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy*