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Surveillance after orchidectomy for patients with clinical stage I nonseminomatous testis tumors.
- Source :
-
Journal of clinical oncology : official journal of the American Society of Clinical Oncology [J Clin Oncol] 1992 Apr; Vol. 10 (4), pp. 564-8. - Publication Year :
- 1992
-
Abstract
- Purpose: This study was designed to determine the proportion of patients with clinical stage I nonseminomatous germ cell tumors of the testis (NSGCTT) managed with surveillance after orchidectomy who have more advanced disease and, therefore, require further treatment, the time to progression, the sites of progression, and the efficacy of treatment delayed until progression was recognized.<br />Patients and Methods: One hundred five patients were observed prospectively without further treatment after orchidectomy and full clinical staging. Treatment was given immediately upon detection of marker-positive, clinical, or radiologic evidence of disease.<br />Results: Thirty-seven patients (35.2%) have required further therapy for disease progression, occurring from 2 to 21 months after diagnosis. Thirty-six patients have been successfully treated. Overall, 104 patients (99%) remain alive and free of disease at 12 to 121 months after orchidectomy. Progression occurred in the retroperitoneum in 25 of 37 patients who developed further disease on surveillance. The presence of vascular invasion in the primary tumor was predictive of an increased risk of progression.<br />Conclusion: Surveillance is a valid alternative to immediate retroperitoneal lymph node dissection in patients with clinical stage I NSGCTT but should be recommended only under the close supervision of physicians experienced in the diagnosis and treatment of testicular cancer.
- Subjects :
- Adolescent
Adult
Aged
Follow-Up Studies
Humans
Male
Middle Aged
Neoplasm Staging
Neoplasms, Germ Cell and Embryonal drug therapy
Prospective Studies
Testicular Neoplasms drug therapy
Time Factors
Neoplasms, Germ Cell and Embryonal secondary
Neoplasms, Germ Cell and Embryonal surgery
Orchiectomy
Testicular Neoplasms pathology
Testicular Neoplasms surgery
Subjects
Details
- Language :
- English
- ISSN :
- 0732-183X
- Volume :
- 10
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of clinical oncology : official journal of the American Society of Clinical Oncology
- Publication Type :
- Academic Journal
- Accession number :
- 1312585
- Full Text :
- https://doi.org/10.1200/JCO.1992.10.4.564