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Late relapse in stage I of nonseminomatous germ cell testicular cancer on surveillance

Publication at First Faculty of Medicine |
2018

Abstract

OBJECTIVE: Primary aim was to assess relapse-free survival (RFS) in patients with clinical stage I (CS I) of non-seminomatous germ cell testicular tumors (NSGCTT) undergoing surveillance after orchiectomy. The secondary aim was to examine differences in risk factors in patients with early relapse (ER 2 years) and very late relapse (VLR > 5 years).

METHODS: Cross-sectional study analyzed 25-year single-center experiences with 198 CS I NSGCTT patients according the time to relapse. RESULTS: RFS was 160/198 (80.8 %).

Relapse occurred in 38 (19.2 %) patients after a median follow-up of 7.57 months, 33 (86.8 %) patients had ER after a median follow-up of 7.03 months and 5 patients had LR (13.2 %) after a median follow-up of 26.28 months. One patient (2.63 %) had VLR after follow-up > 5 years (7.17 years).

Three relapsed patients died with metastatic disease after a mean follow-up of 5.1 years from the date of diagnosis. Another three patients died without cancer after a mean follow-up of two years.

OS was 192/198 (97 %). CONCLUSION: Diagnosis and treatment of late relapsing NSGCTT patients should be performed in experienced centers only.

Occurrence of LR is the reason for long-term monitoring of NSGCTT survivors.