Conditional Risk of Relapse in Surveillance for Clinical Stage I Testicular Cancer

• Published in: European urology 2017-01, Vol.71 (1), p.120-127
• Main Authors: Nayan, Madhur, Jewett, Michael A.S, Hosni, Ali, Anson-Cartwright, Lynn, Bedard, Philippe L, Moore, Malcolm, Hansen, Aaron R, Chung, Peter, Warde, Padraig, Sweet, Joan, O’Malley, Martin, Atenafu, Eshetu G, Hamilton, Robert J
• Format: Article
• Language: English
• Subjects: Germ cell tumor; Humans; Male; Neoplasm Recurrence, Local; Neoplasms, Germ Cell and Embryonal - surgery; Orchiectomy; Prognosis; Recurrence; Risk Factors; Seminoma - surgery; Testicular neoplasm; Testicular Neoplasms - surgery; Treatment outcome; Urology
• ISSN: 0302-2838; 1873-7560
• DOI: 10.1016/j.eururo.2016.07.013

Abstract Background Patients on surveillance for clinical stage I (CSI) testicular cancer are counseled regarding their baseline risk of relapse. The conditional risk of relapse (cRR), which provides prognostic information on patients who have survived for a period of time without relapse, have not been determined for CSI testicular cancer. Objective To determine cRR in CSI testicular cancer. Design, setting, and participants We reviewed 1239 patients with CSI testicular cancer managed with surveillance at a tertiary academic centre between 1980 and 2014. Outcome measurements and statistical analysis cRR estimates were calculated using the Kaplan-Meier method. We stratified patients according to validated risk factors for relapse. We used linear regression to determine cRR trends over time. Results and limitations At orchiectomy, the risk of relapse within 5 yr was 42.4%, 17.3%, 20.3%, and 12.2% among patients with high-risk nonseminomatous germ cell tumor (NSGCT), low-risk NSGCT, seminoma with tumor size ≥3 cm, and seminoma with tumor size