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Interdisciplinary evidence-based recommendations for the follow-up of early stage seminomatous testicular germ cell cancer patients
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Souchon, Rainer, Hartmann, Michael, Krege, Susanne, Lorch, Anja, Mayer, Frank, De Santis, Maria, Gillessen, Silke, Beyer, Jörg and Cathomas, Richard (2011) Interdisciplinary evidence-based recommendations for the follow-up of early stage seminomatous testicular germ cell cancer patients. Strahlentherapie und Onkologie, Volume 187 (Number 3). pp. 158-166. doi:10.1007/s00066-010-2227-x ISSN 0179-7158.
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Official URL: http://dx.doi.org/10.1007/s00066-010-2227-x
Abstract
Purpose:
To provide guidance regarding follow-up procedures after initial treatment of early stage testicular seminoma (clinical stages (CS) I–II A/B) based on current published evidence complemented by expert opinion.
Methods and Material:
An interdisciplinary, multinational working group consisting of urologists, medical oncologists, and radiation oncologists analyzed the published evidence regarding follow-up procedures in various stages of seminomatous and nonseminomatous testicular cancers. Focusing on radiooncological aspects, the recommendations contained herein are restricted to early stage seminoma (with radiotherapy being a standard treatment option). In particular, extent, frequency, and duration of imaging at follow-up were analyzed concerning relapse patterns, risk factors, and mode of relapse detection.
Results:
Active surveillance, adjuvant carboplatin or radiotherapy are equally accepted options for CS I seminoma but they result in different relapse rates and patterns. Usually relapses occur within the first 2(–6) years. Routinely performed follow-up using computerized tomography (CT) after adjuvant treatment yield only low detection rates of recurrences. Therefore, there is no evidence to maintain routine examinations every 3–4 months. After treatment of stage IIA/B, detection rates of relapses or progression identified solely by routinely performed CT during follow-up are low.
Conclusion:
Considering lifelong cure rates of up to 99% for patients treated for seminoma CS I–IIA/B, the negative impact of unnecessary ionizing radiation exposure has to be considered. The presented recommendations for various follow-up scenarios for early stage seminoma strongly promote the restrictive use of imaging procedures that utilize ionizing radiation (especially CT), due to its potential to induce secondary malignancies.
Item Type: | Journal Article | ||||
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Cancer Research Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Journal or Publication Title: | Strahlentherapie und Onkologie | ||||
Publisher: | Springer | ||||
ISSN: | 0179-7158 | ||||
Official Date: | 1 March 2011 | ||||
Dates: |
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Volume: | Volume 187 | ||||
Number: | Number 3 | ||||
Page Range: | pp. 158-166 | ||||
DOI: | 10.1007/s00066-010-2227-x | ||||
Status: | Peer Reviewed | ||||
Publication Status: | Published | ||||
Access rights to Published version: | Restricted or Subscription Access |
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