Patterns of relapse in patients with clinical stage I testicular cancer managed with active surveillance
- Study type
- Observational study
- Design
- Retrospective multicentre study (Canada, Norway, Sweden, the United Kingdom and the United States) based on individual patient data
- Sample size
- 2,483 patients (1,139 non-seminoma and 1,344 seminoma)
- Source
- J Clin Oncol · 2015
In plain words
This large study looked at men with stage 1 testicular cancer who, after surgery, had regular follow-up instead of immediate treatment. Most of them did not have their cancer come back; in those who did, most relapses happened in the first 2 to 3 years and almost all were cured with treatment. Almost none of the patients died of this cancer.
Key results
Treatment arms and regimens
No adjuvant treatment; follow-up with examination, serum markers and imaging according to the participating centres’ schedules.
Source of the regimen details: Abstract of the paper (PubMed 25135991); no adjuvant treatment
Doses are given for the information of specialists, as in this study’s protocol, and are not a prescription. Every drug must be prescribed by the treating physician for the individual patient.
Study population
Patients with clinical stage I testicular cancer managed with active surveillance after orchidectomy; most were treated between 1998 and 2010.
Endpoints
Relapse and death, timing of relapse, extent of disease at relapse and method of relapse detection during active surveillance.
Safety and side effects
One patient with seminoma and two with non-seminoma died of treatment-related events.
Clinical significance and place in guidelines
These data support active surveillance as the preferred option in stage I seminoma and a standard option in stage I non-seminoma (especially without lymphovascular invasion) in current guidelines, and they are used in designing surveillance schedules (focus on the first 2 to 3 years and the role of CT in detecting seminoma relapse).
Limitations
The study is retrospective and surveillance schedules were not the same across centres. Patients were followed in experienced centres, and the results may not apply to less experienced centres or less adherent patients. This card is based on the abstract.
This summary was prepared by the editorial team from the published paper; the original paper is the final reference. Read the original abstract on PubMed.