Patterns of Relapse in Australian Patients With Clinical Stage 1 Testicular Cancer: Utility of the Australian and New Zealand Urogenital and Prostate Cancer Trials Group Surveillance Recommendations

Conduit, C; Lewin, J; Weickhardt, A; Lynam, J; Wong, S; Grimison, P; Sengupta, S; Pranavan, G; Parnis, F; Bastick, P; Campbell, D; Hansen, AR; Leonard, M; McJannett, M; Stockler, MR; Gibbs, P; Toner, G; Davis, ID; Tran, B; Kuchel, A

Author(s): Conduit, C; Lewin, J; Weickhardt, A; Lynam, J; Wong, S; Grimison, P; Sengupta, S; Pranavan, G; Parnis, F; Bastick, P; Campbell, D; Hansen, AR; Leonard, M; McJannett, M; Stockler, MR; Gibbs, P; Toner, G; Davis, ID; Tran, B; Kuchel, A;
Details: Publication Year 2023-11,Volume 19,Issue #11,Page 973-980
Journal Title: JCO Oncology Practice
Publication Type: Research article
Abstract: PURPOSE: International guidelines advocate for active surveillance as the preferred treatment strategy for patients with stage 1 testicular cancer after orchidectomy although a personalized discussion is required. MATERIALS AND METHODS: We conducted an analysis of individuals registered in iTestis, Australia's testicular cancer registry, to describe the patterns of relapse and outcomes of patients treated in Australia where the Australian and New Zealand Urogenital and Prostate Cancer Trials Group Surveillance Recommendations are widely adopted. RESULTS: A total of 650 individuals diagnosed between 2000 and 2020 were included, 63% (411 of 650) seminoma and 37% (239 of 650) nonseminoma. The median age was 34 years (range 14-74). 26% (106 of 411) with seminoma and 15% (36 of 239) nonseminoma received adjuvant chemotherapy. After a median follow-up of 43 months (range 0-267) postorchidectomy, relapse occurred in 10% (43 of 411) of seminoma and 18% (43 of 239) of nonseminoma. The two-year relapse-free survival was 92% (95% CI, 89 to 95) and 82% (95% CI, 78 to 87) in seminoma and nonseminoma, respectively. All relapses (86 of 86) were detected at a routine surveillance visit; 98% (85 of 86) were asymptomatic and detected solely through imaging (62 of 86, 72%), tumor markers (6 of 86, 7%), or a combination (17 of 86, 20%). The most common relapse site was isolated retroperitoneal lymphadenopathy (53 of 86, 62%). No nonpulmonary visceral metastases occurred. At relapse, 98% (84 of 86) had International Germ Cell Cancer Collaborative Group (IGCCCG) good prognosis; 2 of 86 intermediate prognosis (both nonseminoma). No deaths occurred. CONCLUSION: In our cohort of stage 1 testicular cancer, where national surveillance recommendations have been widely adopted, recurrences were detected at routine surveillance visits and, almost exclusively, asymptomatic with IGCCCG good-prognosis disease. This provides reassurance that active surveillance is safe.
Publisher: American Society of Clinical Oncology
Keywords: Male; Humans; Adolescent; Young Adult; Adult; Middle Aged; Aged; *Testicular Neoplasms/epidemiology/therapy; *Seminoma/epidemiology/therapy; New Zealand/epidemiology; Neoplasm Recurrence, Local/epidemiology; Neoplasm Staging; Retrospective Studies; Australia/epidemiology; *Prostatic Neoplasms; Recurrence
Department(s): Medical Oncology
PubMed ID: 37327464
Publisher's Version: https://doi.org/10.1200/OP.23.00191
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2023-12-12 06:19:33

Last Modified: 2024-07-09 05:16:28