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Article: Surveillance in Stage I Seminoma Patients: A Long-Term Assessment

TitleSurveillance in Stage I Seminoma Patients: A Long-Term Assessment
Authors
KeywordsManagement
Outcomes
Seminoma
Testis cancer
Issue Date2010
PublisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/eururo
Citation
European Urology, 2010, v. 57 n. 4, p. 673-678 How to Cite?
AbstractBackground: Following orchidectomy patients with stage I seminoma of the testis may be managed by either surveillance or adjuvant treatment. In view of the very high cure rate, it is important to analyse long-term outcomes. Objective: : To provide data to advise patients on treatment burden and risk of recurrence associated with surveillance. Design, setting, and participants: We audited the case records of 164 stage I seminoma patients registered at the Royal Marsden Hospital who were managed with a surveillance policy between 1980 and 2004 and followed for 1-20 yr (median: 13.5 yr). Measurements: All treatments and patterns of relapse were documented. Results and limitations: Twenty-two of 164 (13%) patients had relapsed at a median of 15.5 mo (range: 6-55 mo) from orchidectomy. Eighteen relapses appeared to be confined to the para-aortic nodes, but 6 of the 13 (46%) men treated with only para-aortic radiotherapy suffered a further relapse at another site. The disease-specific mortality was 1.3%. In the complete series of 164 patients, a total of 50 cycles of chemotherapy and 26 courses of radiotherapy was administered, representing an average of 0.46 "treatment units" per patient or an average of 3.45 treatment units per relapsing patient. The total number of treatment days was 390 d for radiotherapy and 133 d for chemotherapy, representing an average of 3.2 d per patient or 23.8 d per relapsing patient. This was a single-centre series extending back to the 1980s. Imaging and treatment protocols have advanced since then. Conclusions: Surveillance postorchidectomy is a safe practice in the long term, and the majority of patients can avoid further treatment. There is the risk that those who do relapse face a higher burden of treatment than would be required if adjuvant treatment had been given. © 2009 European Association of Urology.
Persistent Identifierhttp://hdl.handle.net/10722/132642
ISSN
2015 Impact Factor: 14.976
2015 SCImago Journal Rankings: 7.348
ISI Accession Number ID
Funding AgencyGrant Number
NHS
Institute of Cancer Research (ICR)
Cancer Research UK (CUK)C46/A3970
Funding Information:

Funding/Support and role of the sponsor: This work was undertaken at The Royal Marsden NHS Foundation Trust, which received a proportion of its funding from the NHS Executive; we acknowledge NHS funding to the NIHR Biomedical Research Centre. The views expressed in this publication are those of the authors and not necessarily those of the NHS Executive. This work was supported by the Institute of Cancer Research (ICR), and Cancer Research UK (CUK) grant number C46/A3970 to the ICR Section of Radiotherapy.

References

 

DC FieldValueLanguage
dc.contributor.authorCummins, Sen_HK
dc.contributor.authorYau, Ten_HK
dc.contributor.authorHuddart, Ren_HK
dc.contributor.authorDearnaley, Den_HK
dc.contributor.authorHorwich, Aen_HK
dc.date.accessioned2011-03-28T09:27:20Z-
dc.date.available2011-03-28T09:27:20Z-
dc.date.issued2010en_HK
dc.identifier.citationEuropean Urology, 2010, v. 57 n. 4, p. 673-678en_HK
dc.identifier.issn0302-2838en_HK
dc.identifier.urihttp://hdl.handle.net/10722/132642-
dc.description.abstractBackground: Following orchidectomy patients with stage I seminoma of the testis may be managed by either surveillance or adjuvant treatment. In view of the very high cure rate, it is important to analyse long-term outcomes. Objective: : To provide data to advise patients on treatment burden and risk of recurrence associated with surveillance. Design, setting, and participants: We audited the case records of 164 stage I seminoma patients registered at the Royal Marsden Hospital who were managed with a surveillance policy between 1980 and 2004 and followed for 1-20 yr (median: 13.5 yr). Measurements: All treatments and patterns of relapse were documented. Results and limitations: Twenty-two of 164 (13%) patients had relapsed at a median of 15.5 mo (range: 6-55 mo) from orchidectomy. Eighteen relapses appeared to be confined to the para-aortic nodes, but 6 of the 13 (46%) men treated with only para-aortic radiotherapy suffered a further relapse at another site. The disease-specific mortality was 1.3%. In the complete series of 164 patients, a total of 50 cycles of chemotherapy and 26 courses of radiotherapy was administered, representing an average of 0.46 "treatment units" per patient or an average of 3.45 treatment units per relapsing patient. The total number of treatment days was 390 d for radiotherapy and 133 d for chemotherapy, representing an average of 3.2 d per patient or 23.8 d per relapsing patient. This was a single-centre series extending back to the 1980s. Imaging and treatment protocols have advanced since then. Conclusions: Surveillance postorchidectomy is a safe practice in the long term, and the majority of patients can avoid further treatment. There is the risk that those who do relapse face a higher burden of treatment than would be required if adjuvant treatment had been given. © 2009 European Association of Urology.en_HK
dc.languageengen_US
dc.publisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/eururoen_HK
dc.relation.ispartofEuropean Urologyen_HK
dc.subjectManagementen_HK
dc.subjectOutcomesen_HK
dc.subjectSeminomaen_HK
dc.subjectTestis canceren_HK
dc.titleSurveillance in Stage I Seminoma Patients: A Long-Term Assessmenten_HK
dc.typeArticleen_HK
dc.identifier.emailYau, T: tyaucc@hku.hken_HK
dc.identifier.authorityYau, T=rp01466en_HK
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1016/j.eururo.2009.06.006en_HK
dc.identifier.pmid19545941-
dc.identifier.scopuseid_2-s2.0-77249114673en_HK
dc.identifier.hkuros216954-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-77249114673&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume57en_HK
dc.identifier.issue4en_HK
dc.identifier.spage673en_HK
dc.identifier.epage678en_HK
dc.identifier.isiWOS:000275739300031-
dc.publisher.placeNetherlandsen_HK
dc.identifier.scopusauthoridCummins, S=37011994400en_HK
dc.identifier.scopusauthoridYau, T=23391533100en_HK
dc.identifier.scopusauthoridHuddart, R=7006638051en_HK
dc.identifier.scopusauthoridDearnaley, D=7004428943en_HK
dc.identifier.scopusauthoridHorwich, A=34770538800en_HK
dc.identifier.citeulike5197298-

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