Surveillance of stage I testicular seminoma: British Columbia Cancer Agency Experience 1992 to 2002.
OBJECTIVE
To review the changes in the use of surveillance in Stage I seminoma in British Columbia during the past decade and to compare the relapse rates provincially against those in published reports. Postorchiectomy surveillance of Stage I seminoma is an alternative to adjuvant radiotherapy. The relapse rate from a pooled surveillance series was 18% at 5 years.


METHODS
We reviewed the British Columbia Cancer Agency Tumour Registry records for all cases registered with a diagnosis of seminoma of the testes referred to the BCCA between 1992 and 2002. Patients not treated with radiotherapy within 4 months of referral were reviewed for patient and disease parameters (age, rete testes invasion, size, lymphatic invasion), relapse, salvage treatment, and survival.


RESULTS
A total of 458 patients with Stage I seminoma were identified. Of these, 93 went onto surveillance. The annual percentage of patients going onto surveillance increased from 10% in 1992 to 33% by 2002. The median follow-up was 33 months. The 5-year actuarial relapse-free survival rate was 78%. Relapse was more common in those with known adverse prognostic factors (rete invasion or size greater than 4 cm). The actuarial 5-year relapse free rate was 86%, 71%, and 50% for patients with no risk factor, one risk factor, or both risk factors, respectively. The disease-specific survival rate at 5 years was 96%.


CONCLUSIONS
Surveillance of patients with seminoma in British Columbia increased between 1992 and 2002. The relapse and survival rates in this population-based series were similar to those previously reported.
Tyldesley
Scott
S
Radiation Therapy Program, British Columbia Cancer Agency, Vancouver Cancer Centre, Vancouver, British Columbia, Canada. styldesl@bccancer.bc.ca
Voduc
David
D
McKenzie
Michael
M
Duncan
Graeme
G
Liu
Mitchell
M
Wu
Douglas
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001955:British Columbia; D018572:Disease-Free Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D009367:Neoplasm Staging; D011159:Population Surveillance; D018239:Seminoma / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy*; D015996:Survival Rate; D013736:Testicular Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy*