TREATMENT OF STAGE-I TESTICULAR-TUMORS

Between 1980 and 1989, 138 patients with stage I carcinoma of the test es were treated and followed up; 81 patients had seminoma and 57 had n on-seminomatous tumours. Between January 1980 and December 1983, patie nts with seminoma were treated by orchiectomy, followed by complementa ry radiotherapy to aortic and ipsilateral pelvic nodes. Retroperitonea l lymph node dissection (RPLND) was performed in patients with non-sem inomatous tumours. After January 1984 the treatment strategy was chang ed and orchiectomy was followed by a surveillance policy in all histol ogical types. In seminoma patients, 1 of 36 patients (3%) treated with complementary radiotherapy and 5 of 45 (11%) on the surveillance poli cy relapsed. All achieved a complete response after chemotherapy. In n on-seminomatous tumours, 3 of 21 patients (14%) treated with complemen tary lymphadenectomy relapsed, in contrast to 11 of 36 (31%) surveilla nce policy patients. All patients who relapsed obtained a complete res ponse with chemotherapy. All patients are currently free of disease. T here were no differences in survival between both treatment policies. We conclude that a wait and see policy in stage I testicular tumours i s feasible and provides the same results as more interventionist pract ices.