Surveillance results of patients with stage I nonseminomatous germ cell testicular cancer.

BACKGROUND

The aim of this study was to evaluate the efficacy of active surveillance after radical orchiectomy in patients with clinical stage I nonseminoma.

PATIENTS AND

METHODS

Between 2002 and 2009, the charts of 80 patients who were offered active surveillance were studied retrospectively. Patients underwent clinical, radiologic, and biochemical examinations according to NCCN follow-up guidelines in nonseminoma.

RESULTS

70 of 80 patients who accepted this strategy were analyzed. 12 of the 70 patients (17%) had relapses with a median follow-up of 18.5 months (6-76). Relapses were found in retroperitoneal lymph nodes in 3 patients. 5 patients had marker relapse, and 4 patients developed both marker relapse and retroperitoneal lymph node metastases. 10 of the 12 patients (83%) had relapsed within 1 year. There were no statistically significant differences in lymphovascular invasion and germ cell components between relapsed and non-relapsed patients. 11 of the 12 patients were treated with cisplatinbased combination chemotherapy, and 1 patient underwent retroperitoneal lymph node dissection. Only 2 patients underwent primary retroperitoneal lymph node dissection for rest nodules.

CONCLUSIONS

Surveillance could be a reliable strategy in compliant stage I nonseminoma patients. Recurrences can be detected early and treated successfully.