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- Publisher Website: 10.1016/j.eururo.2009.06.006
- Scopus: eid_2-s2.0-77249114673
- PMID: 19545941
- WOS: WOS:000275739300031
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Article: Surveillance in Stage I Seminoma Patients: A Long-Term Assessment
Title | Surveillance in Stage I Seminoma Patients: A Long-Term Assessment | ||||||||
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Authors | |||||||||
Keywords | Management Outcomes Seminoma Testis cancer | ||||||||
Issue Date | 2010 | ||||||||
Publisher | Elsevier 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? | ||||||||
Abstract | Background: 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 Identifier | http://hdl.handle.net/10722/132642 | ||||||||
ISSN | 2021 Impact Factor: 24.267 2020 SCImago Journal Rankings: 9.799 | ||||||||
ISI Accession Number ID |
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 Field | Value | Language |
---|---|---|
dc.contributor.author | Cummins, S | en_HK |
dc.contributor.author | Yau, T | en_HK |
dc.contributor.author | Huddart, R | en_HK |
dc.contributor.author | Dearnaley, D | en_HK |
dc.contributor.author | Horwich, A | en_HK |
dc.date.accessioned | 2011-03-28T09:27:20Z | - |
dc.date.available | 2011-03-28T09:27:20Z | - |
dc.date.issued | 2010 | en_HK |
dc.identifier.citation | European Urology, 2010, v. 57 n. 4, p. 673-678 | en_HK |
dc.identifier.issn | 0302-2838 | en_HK |
dc.identifier.uri | http://hdl.handle.net/10722/132642 | - |
dc.description.abstract | Background: 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.language | eng | en_US |
dc.publisher | Elsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/eururo | en_HK |
dc.relation.ispartof | European Urology | en_HK |
dc.subject | Management | en_HK |
dc.subject | Outcomes | en_HK |
dc.subject | Seminoma | en_HK |
dc.subject | Testis cancer | en_HK |
dc.title | Surveillance in Stage I Seminoma Patients: A Long-Term Assessment | en_HK |
dc.type | Article | en_HK |
dc.identifier.email | Yau, T: tyaucc@hku.hk | en_HK |
dc.identifier.authority | Yau, T=rp01466 | en_HK |
dc.description.nature | link_to_subscribed_fulltext | en_US |
dc.identifier.doi | 10.1016/j.eururo.2009.06.006 | en_HK |
dc.identifier.pmid | 19545941 | - |
dc.identifier.scopus | eid_2-s2.0-77249114673 | en_HK |
dc.identifier.hkuros | 216954 | - |
dc.relation.references | http://www.scopus.com/mlt/select.url?eid=2-s2.0-77249114673&selection=ref&src=s&origin=recordpage | en_HK |
dc.identifier.volume | 57 | en_HK |
dc.identifier.issue | 4 | en_HK |
dc.identifier.spage | 673 | en_HK |
dc.identifier.epage | 678 | en_HK |
dc.identifier.isi | WOS:000275739300031 | - |
dc.publisher.place | Netherlands | en_HK |
dc.identifier.scopusauthorid | Cummins, S=37011994400 | en_HK |
dc.identifier.scopusauthorid | Yau, T=23391533100 | en_HK |
dc.identifier.scopusauthorid | Huddart, R=7006638051 | en_HK |
dc.identifier.scopusauthorid | Dearnaley, D=7004428943 | en_HK |
dc.identifier.scopusauthorid | Horwich, A=34770538800 | en_HK |
dc.identifier.citeulike | 5197298 | - |
dc.identifier.issnl | 0302-2838 | - |