Outcome of different post-orchiectomy management for stage I seminoma: Japanese multi-institutional study including 425 patients.

Abstract

OBJECTIVES:

To clarify the contemporary clinical outcome of stage I seminoma and to provide information on treatment options to patients.

METHODS:

A retrospective analysis of 425 patients who underwent orchiectomy for stage I seminoma between 1985 and 2006 at 25 hospitals in Japan. Relapse-free survival rates were calculated using the Kaplan-Meier method and clinicopathological factors associated with relapse were examined by univariate and multivariate analyses using the Cox proportional hazards model.

RESULTS:

A total of 30 out of 425 patients had relapsed. Relapse-free survival rates at 10 years were 79, 94 and 94% in the surveillance, chemotherapy and radiotherapy groups, respectively. Post-orchiectomy management and rete testis invasion were identified as independent predictive factors associated with relapse. Rete testis invasion remained to be an independent predictive factor, even if the cases with relapses in the contralateral testis were censored. Only one patient, who relapsed after adjuvant radiotherapy, died of the disease. Overall survival at 10 years was 100, 100 and 99% in the surveillance, chemotherapy and radiotherapy groups, respectively. More than half of the patients were lost to follow up within 5 years.

CONCLUSIONS:

The outcome of Japanese patients with stage I seminoma is similar to previously published Western reports. Surveillance policy is becoming a popular option in Japan, although the relapse rate in patients opting for surveillance policy is higher than those opting for adjuvant chemotherapy or radiotherapy. Rete testis invasion is an independent predictive factor associated with relapse regardless of the post-orchiectomy management. Long-term follow up is mandatory for detection of late relapse.

• Authors: Tomomi Kamba, Toshiyuki Kamoto, Kazutoshi Okubo, Satoshi Teramukai, Yoshiyuki Kakehi, Tadashi Matsuda, Osamu Ogawa
• Journal: International journal of urology : official journal of the Japanese Urological Association (Int J Urol) Vol. 17 Issue 12 Pg. 980-7 (Dec 2010) ISSN: 1442-2042 [Electronic] Australia
• PMID: 20955354 (Publication Type: Journal Article, Multicenter Study)
• Copyright: © 2010 The Japanese Urological Association.

Topics

• Adult
• Aged
• Aged, 80 and over
• Disease-Free Survival
• Follow-Up Studies
• Humans
• Japan
• Kaplan-Meier Estimate
• Male
• Middle Aged
• Neoplasm Staging
• Orchiectomy
• Population Surveillance
• Predictive Value of Tests
• Retrospective Studies
• Seminoma (pathology, surgery, therapy)
• Testicular Neoplasms (pathology, surgery, therapy)
• Treatment Outcome
• Young Adult