Introduction

Post-orchidectomy management option in stage 1 seminoma includes adjuvant carboplatin, para-aortic lymph node radiotherapy or surveillance. We aimed to review the patterns of care, factors impacting treatment choice and outcomes for stage 1 seminoma.

Methods:

For all patients with stage 1 seminoma treated between June 2006 and June 2012, clinical and tumour characteristics were obtained by retrospective chart review. Follow up for surveillance was conducted every three months for the first two years, every six months in the third to fifth years; annual visit thereafter until tenth year. Non-compliance to follow up was defined as consecutively missing three follow up clinics. The association between variables and treatment was assessed using logistic regression analysis.

Results:

Seventy-one patients of median age (range) 35 (20-63) years were treated. Sixty-two patients received adjuvant carboplatin, six underwent surveillance and one patient had adjuvant radiotherapy. The pathological variables are presented in table 1. With a median follow up of 22 months, no patients had relapsed or died. There appears to be no clear relationship between clinico-pathological variables and choice of treatment, but meaningful statistical analysis was precluded by a significant imbalance between chemotherapy and surveillance groups. There were 2/6 (33%) patients undergoing surveillance and 15/62 (24%) undergoing chemotherapy who were non-compliant. 

Conclusions:

We confirm the excellent prognosis of patients with stage 1 seminoma regardless of adjuvant treatment option. At our institution, adjuvant carboplatin was strongly favoured in the post-orchidectomy management of stage I seminoma.

Table 1: Pathology variables

Abbreviations: LDH, lactate dehydrogenase; BHCG, Beta human chorionic gonadotropin; LVI, lymphovascular invasion