Seminoma Clinical Stage 1 - Patterns of Care in Germany.
BACKGROUND
International guidelines are ambivalent regarding the recommendations for the management of clinical stage 1 (CS1) seminoma.


METHODS
During 2008-2013, 1,050 patients with seminoma CS1 were prospectively registered with regard to assessing management modality (radiotherapy, carboplatin, surveillance). Associations with tumor size, rete testis invasion, age, year of diagnosis, type of institution, and geographic location were assessed.


RESULTS
Of the total number of patients, 49.3% received carboplatin 1 course, 8.5% carboplatin 2 courses, 35.9% surveillance, and 6.3% radiotherapy. In 2013, surveillance increased significantly to 57.9%. Treatment decisions were significantly associated with rete testis invasion and tumor size. Carboplatin was applied significantly more in office clinics than elsewhere. There is some regional variation regarding treatment preferences.


CONCLUSIONS
The rising acceptance of surveillance mirrors international trends. The associations with prognostic factors demonstrate care givers to be compliant with contemporary guidelines. The association with the type of institution suggests non-oncological factors to be also relevant in decision making.
Klinik fx00FC;r Urologie, Albertinen-Krankenhaus Hamburg, Hamburg, Germany.
Klaus-Peter
KP
Dieckmann
Inken
I
Dralle-Filiz
Julia
J
Heinzelbecker
Cord
C
Matthies
Jens
J
Bedke
Jörg
J
Ellinger
Jörg
J
Sommer
Björn
B
Haben
Rainer
R
Souchon
Petra
P
Anheuser
Uwe
U
Pichlmeier
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000066491:Clinical Decision-Making; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010818:Practice Patterns, Physicians'; D011446:Prospective Studies; D018239:Seminoma / Q000473:pathology / Q000628:therapy*; D013736:Testicular Neoplasms / Q000473:pathology / Q000628:therapy*; D057832:Watchful Waiting / Q000706:statistics & numerical data; D055815:Young Adult