Surveillance of stage I testicular seminoma: British Columbia Cancer Agency Experience 1992 to 2002

Objectives To review the changes in the use of surveillance in Stage I seminoma in British Columbia during the past decade and to compare the relapse rates provincially against those in published reports. Postorchiectomy surveillance of Stage I seminoma is an alternative to adjuvant radiotherapy. The relapse rate from a pooled surveillance series was 18% at 5 years. Methods We reviewed the British Columbia Cancer Agency Tumour Registry records for all cases registered with a diagnosis of seminoma of the testes referred to the BCCA between 1992 and 2002. Patients not treated with radiotherapy within 4 months of referral were reviewed for patient and disease parameters (age, rete testes invasion, size, lymphatic invasion), relapse, salvage treatment, and survival. Results A total of 458 patients with Stage I seminoma were identified. Of these, 93 went onto surveillance. The annual percentage of patients going onto surveillance increased from 10% in 1992 to 33% by 2002. The median follow-up was 33 months. The 5-year actuarial relapse-free survival rate was 78%. Relapse was more common in those with known adverse prognostic factors (rete invasion or size greater than 4 cm). The actuarial 5-year relapse free rate was 86%, 71%, and 50% for patients with no risk factor, one risk factor, or both risk factors, respectively. The disease-specific survival rate at 5 years was 96%. Conclusions Surveillance of patients with seminoma in British Columbia increased between 1992 and 2002. The relapse and survival rates in this population-based series were similar to those previously reported.