Patterns of relapse in patients with clinical stage I testicular cancer managed with active surveillance

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Kollmannsberger C., Tandstad T., Bedard P.L., Cohn-Cedermark G., Chung P.W., Jewett M.A., Powles T., Warde P.R., Daneshmand S., Protheroe A., Tyldesley S., Black P.C., Chi K., So A.I., Moore M.J., Nichols C.R.

Journal of Clinical Oncology 2015 33:1 (51-57)

Purpose: To evaluate the performance of active surveillance as a management strategy in broad populations and to inform the development of surveillance schedules by individual patient data regarding timing and type of relapse. Methods: Retrospective study including data from 2,483 clinical stage I (CSI) patients, 1,139 CSI nonsemi-noma and 1,344 CSI seminoma managed with active surveillance, with the majority treated between 1998 and 2010. Clinical outcomes including relapse and death, time distribution, extent of relapse and method of relapse detection observed on active surveillance were recorded. Results: Relapse occurred in 221 (19%) CSI-nonseminoma and 173 (13%) CSI-seminoma patients. Median time to relapse was 4 months (range, 2-61 months), 8 months (range, 2-77 months) and 14 months (range, 2-84 months) for lymphovascular invasion-positive CSI nonseminoma, lymphovascular invasion-negative CSI nonseminoma and CSI seminoma. Most relapses were observed within the first 2 years/3 years after orchiectomy for CSI nonseminoma (90%)/CSI seminoma (92%). Relapses were detected by computed…(vermás)


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