WASHINGTON, DC USA (UroToday.com) - Management of stage I testis cancer has changed. Active surveillance (AS) is commonly offered and practiced for stage I disease.
If cancer recurs and is identified on active surveillance, salvage treatments are highly successful. Late relapses after 2 years occur in 3% for NSGCT and up to 15% of seminomas. Thus, long-term surveillance is needed. This group examined how closely AS protocols are followed, and found that 30% had no CT or CXR in the first year and these numbers increased more over time! Limiting radiation exposure is important in men undergoing frequent CT scans. There is a 1.9% lifetime risk of secondary malignancy in lifetime surveillance of an 18 year old. Average nodal growth rates have been determined and it is suggests that CT scanning at 6.6-month intervals is adequate to detect recurrence without compromising detection and salvage therapy. Low dose CT scanning is an option and only 1% of these scans is unacceptable and then requires full dose scanning. It is suggested that CXR will detect most chest recurrences and this can decrease radiation exposure. He concluded that AS is best continued for 10 years, due to late relapses.
Presented by Christopher Saigal, MD at the Society for Basic Urologic Research (SBUR)/Society of Urologic Oncology (SUO) joint meeting during the American Urological Association (AUA) Annual Meeting - May 14 - 19, 2011 - Walter E. Washington Convention Center, Washington, DC USA
Reported for UroToday by Christopher P. Evans, MD, FACS, Professor and Chairman, Department of Urology, University of California, Davis, School of Medicine.
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