TREATMENT RESULTS AND LONG-TERM FOLLOW-UP IN STAGE-I SEMINOMA PATIENTS

Between 1979 and 1992 seventy-nine patients with seminoma were treated at our institution, 62 of them with stage I. The mean follow-up time was 6.0 years (range: 36 months to 14 years). Preoperatively, serum be ta human chorionic gonadotropin (beta-HCG) was elevated in 12 cases (1 9%) without prognostic significance. In addition to orchiectomy, 57 pa tients with stage I seminoma of the testis received adjuvant radiother apy (mean dose: 33 Gy). Two patients were treated with primary retrope ritoneal lymph node dissection (RPLND) and one patient with cisplatin- based chemotherapy. In 2 cases a surveillance strategy was used. Three patients (5%) had a relapse of the seminoma (2 in the retroperitoneum and one suprainguinally). The time interval between orchiectomy and r elapse was 5 to 60 months. Salvage treatment consisted of chemotherapy and RPLND in 2 patients and chemotherapy and resection of the suprain guinal recurrent mass in one patient, and was successful in all 3 pati ents. A total of 60 patients evaluated (100%) are still alive with no evidence of disease. In conclusion, adjuvant radiotherapy is considere d the routine treatment in seminomas stage I despite studies with a 'w ait and watch' policy or a carboplatin monotherapy.