J Korean Soc Ther Radiol Oncol.  2009 Jun;27(2):49-54. 10.3857/jkstro.2009.27.2.49.

Is Radiotherapy Necessary for Stage 1 Testicular Seminoma?

• Lee JA
• Park W
• Lim DH
• Ahn YC
• Huh SJ
• Yu JI
• Choi HY
• Lee HM
• Cho EY

• KMID: 2198478
• DOI: http://doi.org/10.3857/jkstro.2009.27.2.49

Abstract

PURPOSE: To report on the clinical outcome of patients with stage I testicular seminoma by postoperative radiotherapy (PORT) or surveillance after radical inguinal orchiectomy.
MATERIALS AND METHODS
This study is a retrospective review of 32 stage I pure seminoma patients treated between 1996 and 2005 at the Samsung Medical Center. Twenty two of the patients were treated by PORT, which was directed at the paraaortic lymphatics with a median dose of 25.2 Gy in 14 fractions for 3 weeks. The 10 remaining patients were managed by surveillance. The median follow-up period was 96 months with a range of 24 to 155 months.
RESULTS
Clinically, most patients presented with a testicular mass or discomfort. Two of the patients had a history of undescended testes. Pathologically, 23 of the patients had intratubular germ cell neoplasia with seminoma. Both recurrence-free survival (RFS) and overall survival (OS) rates of patients treated by PORT were 100%. In the control group, 1 of the 10 patients suffered a para-aortic lymph node relapse. The RFS and OS rates of the surveillance group were 88.9% and 100%, respectively.
CONCLUSION
No difference in survival was observed between the two groups. Moreover, symptom recurrence was only observed in 1 patient in the control group. The use of PORT may reduce the risk of relapse. With the availability of effective diagnostic and salvage modalities, surveillance monitoring may be considered for patients in good compliance.

Keyword

Seminoma; Radical orchiectomy; Radiation therapy; Surveillance

MeSH Terms

Compliance
Cryptorchidism
Follow-Up Studies
Germ Cells
Humans
Lymph Nodes
Male
Orchiectomy
Recurrence
Retrospective Studies
Seminoma