A SURVEILLANCE STUDY OF CLINICAL STAGE-I NONSEMINOMATOUS GERM-CELL TUMORS OF THE TESTIS - 10-YEAR FOLLOW-UP

Purpose: We evaluate the 10-year results of a surveillance study of cl inical stage I nonseminomatous germ cell tumors of the testis. Materia ls and Methods: Between 1981 and 1984 we recruited 85 consecutive eval uable patients with nonseminomatous germ cell tumors of the testis and normal post-orchiectomy physical examination, chest x-rays, bipedal l ymphangiography, abdominal scans and serum tumor markers. The patients were followed for at least 10 years after orchiectomy alone, which wa s performed elsewhere in 90% of the cases. Results. The interval betwe en visits was twice as long as it was scheduled. Relapses occurred in 25 patients (29.4%) after a median disease-free interval of 7 months ( range 2 to 68). Five patients had further relapses and 3 (3.5%) died o f cancer. Retroperitoneal relapses (19%) occurred later than lung rela pses, and they were diagnosed when larger than 5 cm. in 7 patients. Th e percentage of embryonal carcinoma within the tumor associated with r elapse (p = 0.008), T category (p = 0.023), scrotal violation (p = 0.0 42) and vascular invasion (p = 0.063) had a weak correlation but data on T category and vascular invasion were available for only some patie nts. Conclusions: Surveillance is a difficult type of study and missin g data may compromise the therapeutic program based on prognostic fact ors.