RISK-ADAPTED FOLLOW-UP FOR GERM-CELL TUMO RS

Results in 503 patients with germ cell testicular tumors treated betwe en 1982 and 1992 were analyzed. A follow-up program for germ cell tumo rs is presented which is related to the individual risk of tumor relap se, The overall relapse rate was 7 %, of which 82 % had recurrent tumo r within 1 year after treatment. A low risk of relapse (3-5 %) is seen in patients with seminoma stage I and radiation and, usually, in earl y-stage patients treated with polychemotherapy, A moderate risk of rel apse (6-11 %) is observed in patients with non-seminoma stage I and ly mphadenectomy without chemotherapy. Seminoma without radiation and non -seminoma without lymphadenectomy in clinical stage I, non-seminoma st age IIa and IIb without adjuvant chemotherapy after lymphadenectomy, a nd primary high tumor mass present a high risk of relapse (> 11 %). Tu mor recurrence is localized mainly in lung and retroperitoneum. Most i mportant in the follow-up are tumor marker and chest X-ray. During the first year examinations should take place every 3 months in the low-r isk group and every 2 months in the moderate and high risk group. Comp uter tomography is only required in high-risk patients. Usually a 3-ye ar follow-up is sufficient.