title: Controversies in the management of clinical stage I nonseminomatous germ cell testicular cancer.
abstract: Surveillance after orchiectomy alone has become popular in the management of clinical stage I of nonseminomatous germ cell testicular tumors (CSI NSGCTT). Efforts to identify patients at high-risk of relapse led to a search for risk factors in CSI NSGCTT. The aim of the current study was to analyze longterm experiences with risk-adapted therapeutic approaches (active surveillance and adjuvant chemotherapy). From 1/ 1992 to 2/ 2015, a total of 454 CSI NSGCTT patients were included in the study and stratified into two groups according to risk-adapted therapeutic approaches. In Group A (low- risk CSI NSGCTT), which consisted of 287 patients who underwent surveillance, relapse occurred in 48 (16.7%) patients with a median followup of 7.0 months. Six patients (2.1%) of this group died with a median followup of 34.3 months. In Group B (high-risk CSI NSGCTT), which consisted of 167 patients who were treated with adjuvant chemotherapy, relapse occurred in two (1.2%) patients with a median followup of 56.2 months. One patient (0.6%) died 139.4 months following orchiectomy. Statistically significant difference in progression free survival between these two groups was found, but no significant difference in overall survival.Key words: testicular cancer -  surveillance -  adjuvant chemotherapy -  disease progression.
authors.forename: D
authors.initials: D
authors.lastname: Ondrus
authors.forename: K
authors.initials: K
authors.lastname: Kajo
authors.forename: V
authors.initials: V
authors.lastname: Stastna
authors.forename: M
authors.initials: M
authors.lastname: Ondrusova
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage; D017024:Chemotherapy, Adjuvant; D003430:Cross-Sectional Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009367:Neoplasm Staging; D009373:Neoplasms, Germ Cell and Embryonal / Q000473:pathology / Q000628:therapy*; D009919:Orchiectomy; D011379:Prognosis; D012307:Risk Factors; D016019:Survival Analysis; D013736:Testicular Neoplasms / Q000473:pathology / Q000628:therapy*; D057832:Watchful Waiting; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents