title: Stage I seminoma: treatment outcome at King Hussein Cancer Center in Jordan.
abstract: BACKGROUND
  The aim of this report is to address treatment outcomes of patients with early-stage seminoma in a single institution with special reference to patients with history of surgical violation of the scrotum.
  
  
  METHODS
  Seventy four patients with pure seminoma were treated at King Hussein Cancer Center (Amman, Jordan) between 2003 and 2010. All patients underwent orchiectomy. All but 3 patients received adjuvant radiotherapy. Patients who underwent surgical violation of the scrotum prior to referral were managed by further excision or irradiation of the scrotal scar. The follow-up ranged from 1 to 200 months (mean, 33 months).
  
  
  RESULTS
  At the time of follow-up; all but one patient remain alive. The 3-year relapse-free survival for the entire cohort was 95.9%. Three patients developed relapse, all of whom received adjuvant irradiation following inguinal orchiectomy and initially harbored tumors larger than 4 cm upon pathological examination. Median time to relapse was 14 months (range, 8-25 months). None were associated with elevated tumor markers prior to detection of relapse. All but one patient were successfully salvaged by chemotherapy.
  
  
  CONCLUSIONS
  Our results confirm the excellent prognosis of patients with early-stage seminoma treated by orchiectomy and adjuvant radiotherapy in a developing country. Although all patients who developed relapse demonstrated adverse pathological findings upon initial assessment, no consistent predictor of relapse was found. Scrotal scar re-excision or irradiation in patients with prior history of surgical violation of the scrotum are effective measures in preventing local failure.
authors.affiliation: Department of Radiation Oncology, King Hussein Cancer Center, Queen Rania Alabdulla Street, Amman 11941, Jordan. jkhader@khcc.jo
authors.forename: Jamal
authors.initials: J
authors.lastname: Khader
authors.forename: Ahmed
authors.initials: A
authors.lastname: Salem
authors.forename: Yazan
authors.initials: Y
authors.lastname: Abuodeh
authors.forename: Abdelateif
authors.initials: A
authors.lastname: Almousa
authors.forename: Naim
authors.initials: N
authors.lastname: Farah
authors.forename: Fadwa
authors.initials: F
authors.lastname: Abdelrahman
mesh_terms: D000293:Adolescent; D000328:Adult; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D007597:Jordan; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009919:Orchiectomy / Q000379:methods*; D011379:Prognosis; D018714:Radiotherapy, Adjuvant / Q000379:methods*; D018239:Seminoma / Q000628:therapy*; D013736:Testicular Neoplasms / Q000628:therapy*; D016896:Treatment Outcome