title: Pelvic recurrence in stage I seminoma: a new phenomenon that questions modern protocols for radiotherapy and follow-up.
abstract: OBJECTIVE
  To highlight the increased risk for pelvic relapse in patients with stage 1 seminoma treated with adjuvant radiotherapy limited to para-aortic template alone.
  
  
  METHODS
  Over a four-year period, three patients presented with early pelvic recurrence after radical orchidectomy and adjuvant irradiation for stage 1 seminoma. In each case, radiotherapy had been limited to the para-aortic region with omission of the ipsilateral hemi pelvis.
  
  
  RESULTS
  Pelvic recurrences occurred on the ipsilateral tumor side. Durable complete remission was achieved in each case; however, treatment was complex and there was associated morbidity.
  
  
  CONCLUSIONS
  This significant incidence of pelvic recurrence questions the validity of modern radiotherapy protocol which excludes the ipsilateral pelvis from the radiation field.
authors.affiliation: The Adelaide and Meath Hospital Incorporating the National Children's Hospital, Tallaght, Dublin, Ireland.
authors.forename: Richard E
authors.initials: RE
authors.lastname: Power
authors.forename: John
authors.initials: J
authors.lastname: Kennedy
authors.forename: John
authors.initials: J
authors.lastname: Crown
authors.forename: Ian
authors.initials: I
authors.lastname: Fraser
authors.forename: John A
authors.initials: JA
authors.lastname: Thornhill
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001761:Bleomycin / Q000008:administration & dosage / Q000627:therapeutic use; D002945:Cisplatin / Q000008:administration & dosage / Q000627:therapeutic use; D005047:Etoposide / Q000008:administration & dosage / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000453:epidemiology; D009367:Neoplasm Staging; D009919:Orchiectomy; D010386:Pelvic Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000556:secondary*; D018714:Radiotherapy, Adjuvant; D012074:Remission Induction / Q000379:methods; D018239:Seminoma / Q000532:radiotherapy* / Q000556:secondary / Q000601:surgery; D013736:Testicular Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D014057:Tomography, X-Ray Computed
chemical_list: D001761:Bleomycin; D005047:Etoposide; D002945:Cisplatin