Surveillance for stage I testicular seminoma: a review

There is good evidence that patients with stage I seminoma can be managed e qually well after orchidectomy with surveillance and adjuvant retroperitone al radiation therapy. There is considerable reluctance amongst many physici ans to accept surveillance as a management option in stage I seminoma and t his is largely based on the excellent results achieved with adjuvant retrop eriteonal radiation for many years. However, patients with stags I seminoma have a long life span and it is possible that the long-term sequelae of ra diation treatment could have a negative impact on quality of life and longe vity. It is of utmost importance to continue the study of the long-term eff ects of all current treatment approaches, in particular the risk of inducti on of second malignancies. However, the psychosocial impact on patients of surveillance and other management strategies must also be assessed. Stags I testicular seminoma is highly curable with currently available management approaches and the current challenge for clinicians is to maintain these ex cellent results while minimizing toxicity and individualising treatment to the specific social, economic and emotional circumstances of each patient. Surveillance should be one of the management options offered to patients wi th stage I seminoma. (C) 2001 Elsevier Science Inc. All rights reserved.