title: Management of stage I testicular seminoma over a period of 49 years.
abstract: BACKGROUND
  The aim of this study was to review the treatment, toxicity, and outcomes in patients with stage I seminoma after orchidectomy.
  
  
  METHODS
  A retrospective chart review of all patients with stage I seminoma referred for initial treatment during the last 49 years was performed. Initial treatment approaches, toxicity, and outcomes were analyzed.
  
  
  RESULTS
  A total of 320 patients were seen between 1960 and 2009. Median age at diagnosis was 37 years (range: 20-72), with a median follow-up of 22.7 years (range: 1-48). All patients but 12 were treated with adjuvant radiotherapy. Acute toxicity was mainly gastrointestinal, with 7.6% classified as grade 2. The 10-year disease-specific survival and relapse-free survival were 97.7 and 97.6%, respectively. 8 patients (2.7%) developed a relapse and were managed with chemotherapy. 10 patients died, 6 of the disease and 4 from other causes (disease-free at time of death).
  
  
  CONCLUSIONS
  In the management of stage I seminoma, 3 treatment options are available; currently in the European Consensus, surveillance is the first choice, considering the overall comparable outcome and the low acute and late toxicity. Adjuvant radiotherapy and adjuvant chemotherapy should be considered as alternative options only if the patient declines the surveillance strategy.
authors: Radiotherapy Unit, Azienda Ospedaliero-Universitaria Careggi, Italy. b.detti@dfc.unifi.it
authors: Beatrice
authors: B
authors: Detti
authors: Silvia
authors: S
authors: Scoccianti
authors: Donata
authors: D
authors: Villari
authors: Samantha
authors: S
authors: Cipressi
authors: Angela
authors: A
authors: Sardaro
authors: Gabriele
authors: G
authors: Simontacchi
authors: Lorenzo
authors: L
authors: Livi
authors: Mauro
authors: M
authors: Gacci
authors: Tommaso
authors: T
authors: Cai
authors: Daniela
authors: D
authors: Greto
authors: Isacco
authors: I
authors: Desideri
authors: Giampaolo
authors: G
authors: Biti
mesh_terms: D000328:Adult; D000368:Aged; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000628:therapy; D009367:Neoplasm Staging; D009919:Orchiectomy; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D018239:Seminoma / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D013736:Testicular Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D055815:Young Adult