title: Treatment of a population based sample of men diagnosed with testicular cancer in the United States.
abstract: OBJECTIVE
  Testicular cancer is the most common cancer in men age 25 to 35 years. We examined therapy, compliance with guidelines, and survival in a population based sample of men newly diagnosed with testicular cancer.
  
  
  METHODS
  We analyzed the National Cancer Institute's (NCI) patterns of care data on 702 men diagnosed with testicular cancer in 1999. These studies supplement routine data collection by verifying therapy with the patients' treating physicians. Follow-up for vital status was available through December 31, 2004.
  
  
  RESULTS
  The majority of the men with seminoma were diagnosed while their cancer was localized and more than 80% of received orchiectomy with radiation. For men with seminoma and nonseminoma germ cell tumors (NSGCT), the percent receiving chemotherapy increased markedly as stage increased. More than 90% of men with regional and distant NSGCT received chemotherapy. Less than 25% of men with localized NSGCT received orchiectomy and retroperitoneal lymph node dissection (RPLND), about 40% had surveillance following an orchiectomy alone, and 30% received orchiectomy and chemotherapy.
  
  
  CONCLUSIONS
  The majority of these patients received therapy consistent with guidelines. While there was no significant difference in the use of RPLND in men with localized NSGCT by geographic region, chemotherapy use varied widely. Over 90% of men with localized or regional disease diagnosed in 1999 were alive at the end of 2004. The excellent survival rates point to the need to monitor for late effects of therapy.
authors.affiliation: Department of Medicine, Lackland Air Force Base, San Antonia, TX 78236, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Osswald
authors.forename: Linda C
authors.initials: LC
authors.lastname: Harlan
authors.forename: David
authors.initials: D
authors.lastname: Penson
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Stevens
authors.forename: Limin X
authors.initials: LX
authors.lastname: Clegg
mesh_terms: D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005500:Follow-Up Studies; D018237:Germinoma / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D019983:Guideline Adherence; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009919:Orchiectomy; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011878:Radiotherapy; D012187:Retroperitoneal Space; D018426:SEER Program; D018239:Seminoma / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D015996:Survival Rate; D013736:Testicular Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D016896:Treatment Outcome; D014481:United States; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents
references.citation: J Clin Oncol. 2005 Aug 20;23(24):5757-61
references.pmid: 16110032
references.citation: BJU Int. 2006 Jul;98(1):67-9
references.pmid: 16831145
references.citation: Urol Int. 2005;75(4):304-8
references.pmid: 16327295
references.citation: Ann Oncol. 2004 Sep;15(9):1377-99
references.pmid: 15319245
references.citation: Lancet. 2005 Jul 23-29;366(9482):293-300
references.pmid: 16039331
references.citation: Urol Oncol. 2006 Jan-Feb;24(1):68-74
references.pmid: 16414498
references.citation: J Clin Oncol. 1997 May;15(5):1844-52
references.pmid: 9164194
references.citation: Urology. 2004 Mar;63(3):556-61
references.pmid: 15028457
references.citation: Cancer. 1999 Nov 15;86(10):2171-83
references.pmid: 10570449
references.citation: J Clin Oncol. 1993 Apr;11(4):598-606
references.pmid: 8386751
references.citation: J Clin Oncol. 2000 Oct 15;18(20):3558-85
references.pmid: 11032599
references.citation: Eur J Cancer. 2006 May;42(7):820-6
references.pmid: 16574403