Diagnostic delay and risk of relapse in patients with stage I nonseminomatous germ cell tumour followed on active surveillance

Objective To determine whether delayed diagnosis affects the outcome of pat ients with stage I nonseminomatous germ cell tumour (NSGCT) followed by a p olicy of 'active surveillance'. Patients and methods A series of 185 consecutive patients with either low-r isk (no vascular invasion) or unknown risk stage I NSGCT referred to Mount Vernon Hospital between 1983 and 1998 were analysed retrospectively for the type and duration of symptoms before orchidectomy, time to relapse, and fo r site and stage of relapse. Results Twenty-six patients (14%) relapsed within a medium follow-up of 98 months. The median (range) time to relapse was 4 (1-14) months. All patient s were effectively salvaged with chemotherapy and in some by surgery. The m edian duration of symptoms before orchidectomy for those patients relapsing was 2 months, and not significantly different from those who did not relap se. Conclusions In patients with stage I NSGCT the duration of symptoms before diagnosis did not influence the probability of relapse.