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Organo Oficial de la Sociedad Mexicana de Urología

2009, Number 5

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Rev Mex Urol 2009; 69 (5)

Stage I seminomatous germ cell tumor management: a comparative analysis

Camarena-Reynoso HR, Vázquez-Ortega L, Hernández-Castellanos V, Mata MP, Leos-Acosta C, Shuck-Bello C, Cantellano-Orozco M, Morales-Montor JG, Pacheco-Gahbler C, Calderón-Ferro F

Language: Spanish
References: 21
Page: 219-223
PDF size: 2310.17 Kb.


ABSTRACT

Introduction: An estimated 70% of seminomatous tumor patients are diagnosed in stage I and only 15-20% will present with micrometastasis. This has led to an ethics controversy concerning the secondary effects of overtreating 80-85% of patients.
Objective: To evaluate stage I seminomatous tumor progression in patients in relation to treatment after orchiectomy.
Materials and methods: A cross-sectional study with a comparative recurrence analysis in relation to treatment and risk factors was carried out.
Results: A total of 57 patients (67%) were identified in stage I. Mean follow-up time was 73 months. Treatment for 66% of patients was surveillance, 11% received chemotherapy and 23% received prophylactic radiotherapy. Seventy percent of patients in the surveillance group were free from disease at 5 years vs. 100% of patients in the other groups. Eighteen percent of patients presented with recurrence. In risk factor analysis, significant difference was found in relation to tumors larger than 4 cm (P‹0.0006) as well as invasion of the rete testis (P‹0.0009).
Conclusions: Management of patients with stage I classic seminoma should be determined in relation to risk factors.


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