Long-term outcome of stage I seminoma.

[djmac]

These guys report 80% relapse rate for surveillance. Still, I don't know how they can draw any conclusions from such small numbers of patients (n=5 in the surveillance group). How does this stuff get published?

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=17414472&query_hl=6&itool=pubmed_docsum

Long-term outcome of stage I seminoma.
Yang GY, Li B, Wagner TD, Donohue KA, Flaherty L, Kuettel MR.
Department of Radiation Medicine, Roswell Park Cancer Institute, Buffalo, NY 14263, USA. [email protected]

PURPOSE: To report on long-term outcomes among patients with stage I seminoma treated by orchiectomy with or without adjuvant radiation. MATERIALS AND METHODS: A retrospective review of medical records of patients treated between 1974 and 2002 was undertaken to identify factors associated with patient outcomes. RESULTS: With a median follow-up of 7.7 years, 80% (4 of 5) of the surveillance group experienced a disease relapse, while only 3% (2 of 70) in the radiation therapy group had disease relapse. This difference in relapse rates was statistically significant, but there was no significant difference in overall survival between the 2 groups. There was a significant relationship between patient age and disease relapse, whereby all of the relapses were seen in patients younger than 36 years at diagnosis (P = 0.03). Of the total 75 patients, 7 (9%) developed second primary tumors. Six of them (6 of 7) were treated with adjuvant radiation, and 1 patient (1 of 7) was on surveillance. CONCLUSION: In this study, risk of relapse was significantly associated with surveillance and in patients younger than 36 years at diagnosis. These results suggest that surveillance can only be safely adopted for patients who can be followed up closely. We consider adjuvant radiation a very effective choice despite the low risk of associated secondary malignancies.

[Scott]

On that page is a link to another study with more familiar statistics from a larger study (n=172 in the surveillance group): "Our surveillance experience showed that four of five patients with stage I seminoma are cured with orchiectomy alone."

[Karen]

I agree, when I saw this I too wondered how it got published. Over a 23 year period they only pulled up 5 patients on surveillance???? We can do a better study from members on this site!

[djmac]

On that page is a link to another study with more familiar statistics from a larger study (n=172 in the surveillance group): "Our surveillance experience showed that four of five patients with stage I seminoma are cured with orchiectomy alone."

Thanks Scott, I know that study well, it's very reassuring especially since I am an older guy, their data suggests a relapse rate of only 10%, although according to the above study my chance of relapse is 0% (since the lone guy that didn't progress was older than 36 ). Love that, n=1 and they have the gall to draw a conclusion!

[Fed]

I've been trying to get the complete manuscript, but HMS doesn't carry the online version of the journal. I'll check the Farber library today. How these things get past referees is beyond me...