title: Posttreatment surveillance after paraaortic radiotherapy for stage I seminoma: a systematic analysis.
abstract: BACKGROUND
  The extent and duration of routine follow-up after paraaortic (PA) radiotherapy for stage I seminoma remain controversial in terms of efficacy, costs of technical investigations and long-term morbidity.
  
  
  OBJECTIVE
  To analyze the current literature assessing routine follow-up after PA radiotherapy for stage I seminoma.
  
  
  METHODS
  We identified all published reports on PA radiotherapy for stage I seminoma (1986-2005). We analyzed time patterns of recurrence, sites and methods of detection of relapse, and follow-up programs used.
  
  
  RESULTS
  We identified 11 publications reporting outcome in 2,280 patients. Median time to recurrence in 80 relapsing patients was 15.5 months. Less than 10% of recurrences were diagnosed beyond the third year of follow-up. Isolated locoregional or distant recurrence was observed in 52 and 20 patients, respectively, without significant difference in median time to relapse. 19 out of 43 recurrences with reported method of detection of relapse were diagnosed by routine technical investigations. There was no significant difference in time to relapse between those patients followed with low volume as compared to high-volume imaging protocols.
  
  
  CONCLUSIONS
  Our data suggest that technical investigations in posttreatment surveillance should be restricted to the first 3 years of follow-up. Furthermore, surveillance programs with a high volume of imaging apparently do not lead to earlier detection or less advanced stage at the time of relapse as compared to protocols with low volume imaging.
authors.affiliation: Department of Radiation Oncology, Tübingen University Hospital, Hoppe-Seyler-Str. 3, 72079, Tübingen, Germany. johannes.classen@vincentius-ka.de
authors.forename: Johannes
authors.initials: J
authors.lastname: Classen
authors.forename: Rainer
authors.initials: R
authors.lastname: Souchon
authors.forename: Thomas
authors.initials: T
authors.lastname: Hehr
authors.forename: Michael
authors.initials: M
authors.lastname: Hartmann
authors.forename: Jörg T
authors.initials: JT
authors.lastname: Hartmann
authors.forename: Michael
authors.initials: M
authors.lastname: Bamberg
mesh_terms: D001011:Aorta; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology / Q000528:radiation effects*; D008207:Lymphatic Metastasis; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D009367:Neoplasm Staging; D011159:Population Surveillance / Q000379:methods; D011879:Radiotherapy Dosage; D018239:Seminoma / Q000000981:diagnostic imaging / Q000517:prevention & control* / Q000532:radiotherapy* / Q000556:secondary; D013736:Testicular Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D013997:Time Factors; D014057:Tomography, X-Ray Computed
references.citation: Eur Urol. 2008 Mar;53(3):497-513
references.pmid: 18191015
references.citation: World J Urol. 2004 Oct;22(4):235-43
references.pmid: 15448994
references.citation: Int J Radiat Oncol Biol Phys. 2005 Mar 1;61(3):741-4
references.pmid: 15708252
references.citation: Clin Oncol (R Coll Radiol). 1992 May;4(3):165-70
references.pmid: 1586633
references.citation: J Cancer Res Clin Oncol. 2001 Aug;127(8):475-81
references.pmid: 11501746
references.citation: J Clin Oncol. 1999 Apr;17(4):1146
references.pmid: 10561173
references.citation: Int J Urol. 2002 Mar;9(3):154-60; discussion 160-1
references.pmid: 12010325
references.citation: Clin Oncol (R Coll Radiol). 1993;5(6):364-6
references.pmid: 8305356
references.citation: Cancer. 1998 Mar 15;82(6):1126-33
references.pmid: 9506359
references.citation: Strahlenther Onkol. 1986 Dec;162(12):735-41
references.pmid: 3810465
references.citation: J Clin Oncol. 2005 Feb 20;23(6):1200-8
references.pmid: 15718317
references.citation: J Clin Oncol. 1996 Nov;14(11):2933-9
references.pmid: 8918490
references.citation: Ann Oncol. 2002 Feb;13(2):237-42
references.pmid: 11886000
references.citation: Strahlenther Onkol. 1999 Jul;175(7):320-4
references.pmid: 10432993
references.citation: Int J Radiat Oncol Biol Phys. 2003 Dec 1;57(5):1304-9
references.pmid: 14630266
references.citation: Int J Cancer. 1999 Dec 10;83(6):823-7
references.pmid: 10597202
references.citation: Eur Urol. 2005 Dec;48(6):885-94
references.pmid: 16126333
references.citation: Acta Oncol. 2005;44(2):142-8
references.pmid: 15788293
references.citation: Int J Radiat Oncol Biol Phys. 1998 Jan 15;40(2):455-9
references.pmid: 9457835
references.citation: Br J Cancer. 2004 Jun 14;90(12):2305-11
references.pmid: 15150576
references.citation: Clin Radiol. 2001 Feb;56(2):116-9
references.pmid: 11222068
references.citation: Strahlenther Onkol. 2009 Jun;185(6):349-54
references.pmid: 19506817
references.citation: Int J Radiat Oncol Biol Phys. 1996 May 1;35(2):293-8
references.pmid: 8635936
references.citation: Cancer. 2000 Jan 1;88(1):162-8
references.pmid: 10618619
references.citation: Lancet. 2005 Jul 23-29;366(9482):293-300
references.pmid: 16039331
references.citation: Eur Urol. 2008 Mar;53(3):478-96
references.pmid: 18191324
references.citation: Drugs. 2006;66(5):641-59
references.pmid: 16620142
references.citation: Clin Oncol (R Coll Radiol). 2001;13(4):296-300
references.pmid: 11554630
references.citation: Anticancer Res. 2001 Jul-Aug;21(4B):2989-93
references.pmid: 11712799
references.citation: Radiother Oncol. 1995 Nov;37(2):164-6
references.pmid: 8747942