POSTORCHIECTOMY SURVEILLANCE IN 11 STAGE I SEMINOMA PATIENTS

Eleven patients with stage I seminoma managed by postorchiectomy surveillance were evaluated at the Okmeydanı Hospital from 1983 to 1987. These patients were managed with orchiectomy alone because they refused and delayed routine postorcihectomy irradiation. The average age at diagnosis was 30 years, range 22-50 years. Eleven cases with stage I seminoma were managed by postorcihectomy surveillance and with a median follow-up of 58 months. The probability of recurring by 2 years was 27.2 percent by 3 years 36 percent. Sites of relapse in three cases have been in the paraaortic region though one patient has developed lung and one kidney metastasis. Two patients developed second reccurrence. Patients who had recurrent disease were salvaged with radiotherapy and chemotherapy and are now without evidence of disease. The maturation of these studies will determine whether postoperative surveillance produces survival rates similar to those obtained with routine postorchiectomy irradiation. Until then, a policy of surveillance is considered suitable only in a protocol setting because of the risk of late relapse or relapse with extensive disease.