Long-term outcome of stage I seminoma.
OBJECTIVE
To report on long-term outcomes among patients with stage I seminoma treated by orchiectomy with or without adjuvant radiation.


METHODS
A retrospective review of medical records of patients treated between 1974 and 2002 was undertaken to identify factors associated with patient outcomes.


RESULTS
With a median follow-up of 7.7 years, 80% (4 of 5) of the surveillance group experienced a disease relapse, while only 3% (2 of 70) in the radiation therapy group had disease relapse. This difference in relapse rates was statistically significant, but there was no significant difference in overall survival between the 2 groups. There was a significant relationship between patient age and disease relapse, whereby all of the relapses were seen in patients younger than 36 years at diagnosis (P = 0.03). Of the total 75 patients, 7 (9%) developed second primary tumors. Six of them (6 of 7) were treated with adjuvant radiation, and 1 patient (1 of 7) was on surveillance.


CONCLUSIONS
In this study, risk of relapse was significantly associated with surveillance and in patients younger than 36 years at diagnosis. These results suggest that surveillance can only be safely adopted for patients who can be followed up closely. We consider adjuvant radiation a very effective choice despite the low risk of associated secondary malignancies.
Yang
Gary Y
GY
Department of Radiation Medicine, Roswell Park Cancer Institute, Buffalo, NY 14263, USA. gary.yang@roswellpark.org
Li
Baoqing
B
Wagner
Timothy D
TD
Donohue
Kathleen A
KA
Flaherty
Leayn
L
Kuettel
Michael R
MR
D000328:Adult; D000368:Aged; D016208:Databases, Factual; D018572:Disease-Free Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012008:Recurrence; D012189:Retrospective Studies; D018239:Seminoma / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy; D016019:Survival Analysis; D013736:Testicular Neoplasms / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy; D013997:Time Factors; D016896:Treatment Outcome