Changing practice evaluation—stage 1 seminoma: outcomes with adjuvant treatment versus surveillance: risk factors for recurrence and optimizing follow-up protocols—experience from a supraregional center
Stage 1 seminoma is frequently cured by radical orchiectomy; however, the management strategies after this diagnosis vary in terms of the use of adjuvant treatment and the nature of the follow-up protocols. We analyzed stage 1 seminomas treated in the Thames Valley Cancer Network for outcomes to det...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
Elsevier
2017
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| _version_ | 1797072470609494016 |
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| author | Tyrrell, H Church, D Joseph, J Traill, Z Sullivan, M Tuthill, M Verrill, C Pintus, E Dallas, N Rogers, P Redgwell, J Protheroe, A |
| author_facet | Tyrrell, H Church, D Joseph, J Traill, Z Sullivan, M Tuthill, M Verrill, C Pintus, E Dallas, N Rogers, P Redgwell, J Protheroe, A |
| author_sort | Tyrrell, H |
| collection | OXFORD |
| description | Stage 1 seminoma is frequently cured by radical orchiectomy; however, the management strategies after this diagnosis vary in terms of the use of adjuvant treatment and the nature of the follow-up protocols. We analyzed stage 1 seminomas treated in the Thames Valley Cancer Network for outcomes to determine whether any factors are predictive of recurrence. We also studied relapses to determine the optimal follow-up schedule and protocol.Data were obtained from centers within the Thames Valley Cancer Network for a 12-year period from 2004 to 2016. We identified 501 patients with stage 1 seminoma.Relapses occurred in 6.2% of the patients receiving adjuvant treatment and 6.1% of those who did not. The only statistically significant predictive factor identified for relapse was rete testis invasion, and the risk was greater when only stromal rete invasion was included, rather than pagetoid as well. A trend was seen toward an increased risk with increased tumor size, but the difference was not statistically significant. Recurrences developed within the first 2 years after surgery in nearly 75% of cases and were identified through surveillance computed tomography scans in 54.8% of the patients. All relapses were treated curatively.Active surveillance leads to excellent outcomes for stage 1 seminoma; however, adjuvant treatment should be reserved for those with high-risk disease. Follow-up schedules should include computed tomography imaging during the first 3 years, long-term measurement of tumor markers, and mechanisms for patients to be seen promptly should symptoms of tumor recurrence occur. |
| first_indexed | 2024-03-06T23:08:08Z |
| format | Journal article |
| id | oxford-uuid:648f752c-58ac-43fd-8ab2-a7aa19314fbd |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T23:08:08Z |
| publishDate | 2017 |
| publisher | Elsevier |
| record_format | dspace |
| spelling | oxford-uuid:648f752c-58ac-43fd-8ab2-a7aa19314fbd2022-03-26T18:19:38ZChanging practice evaluation—stage 1 seminoma: outcomes with adjuvant treatment versus surveillance: risk factors for recurrence and optimizing follow-up protocols—experience from a supraregional centerJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:648f752c-58ac-43fd-8ab2-a7aa19314fbdEnglishSymplectic Elements at OxfordElsevier2017Tyrrell, HChurch, DJoseph, JTraill, ZSullivan, MTuthill, MVerrill, CPintus, EDallas, NRogers, PRedgwell, JProtheroe, AStage 1 seminoma is frequently cured by radical orchiectomy; however, the management strategies after this diagnosis vary in terms of the use of adjuvant treatment and the nature of the follow-up protocols. We analyzed stage 1 seminomas treated in the Thames Valley Cancer Network for outcomes to determine whether any factors are predictive of recurrence. We also studied relapses to determine the optimal follow-up schedule and protocol.Data were obtained from centers within the Thames Valley Cancer Network for a 12-year period from 2004 to 2016. We identified 501 patients with stage 1 seminoma.Relapses occurred in 6.2% of the patients receiving adjuvant treatment and 6.1% of those who did not. The only statistically significant predictive factor identified for relapse was rete testis invasion, and the risk was greater when only stromal rete invasion was included, rather than pagetoid as well. A trend was seen toward an increased risk with increased tumor size, but the difference was not statistically significant. Recurrences developed within the first 2 years after surgery in nearly 75% of cases and were identified through surveillance computed tomography scans in 54.8% of the patients. All relapses were treated curatively.Active surveillance leads to excellent outcomes for stage 1 seminoma; however, adjuvant treatment should be reserved for those with high-risk disease. Follow-up schedules should include computed tomography imaging during the first 3 years, long-term measurement of tumor markers, and mechanisms for patients to be seen promptly should symptoms of tumor recurrence occur. |
| spellingShingle | Tyrrell, H Church, D Joseph, J Traill, Z Sullivan, M Tuthill, M Verrill, C Pintus, E Dallas, N Rogers, P Redgwell, J Protheroe, A Changing practice evaluation—stage 1 seminoma: outcomes with adjuvant treatment versus surveillance: risk factors for recurrence and optimizing follow-up protocols—experience from a supraregional center |
| title | Changing practice evaluation—stage 1 seminoma: outcomes with adjuvant treatment versus surveillance: risk factors for recurrence and optimizing follow-up protocols—experience from a supraregional center |
| title_full | Changing practice evaluation—stage 1 seminoma: outcomes with adjuvant treatment versus surveillance: risk factors for recurrence and optimizing follow-up protocols—experience from a supraregional center |
| title_fullStr | Changing practice evaluation—stage 1 seminoma: outcomes with adjuvant treatment versus surveillance: risk factors for recurrence and optimizing follow-up protocols—experience from a supraregional center |
| title_full_unstemmed | Changing practice evaluation—stage 1 seminoma: outcomes with adjuvant treatment versus surveillance: risk factors for recurrence and optimizing follow-up protocols—experience from a supraregional center |
| title_short | Changing practice evaluation—stage 1 seminoma: outcomes with adjuvant treatment versus surveillance: risk factors for recurrence and optimizing follow-up protocols—experience from a supraregional center |
| title_sort | changing practice evaluation stage 1 seminoma outcomes with adjuvant treatment versus surveillance risk factors for recurrence and optimizing follow up protocols experience from a supraregional center |
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