Ten-year experience in the treatment of clinical stage I seminoma

Background and Objective: Clinical stage I seminoma accounts for 70%-80% of seminoma. This study was to analyze the relationship between different therapeutic methods and the prognosis of this disease. Methods: Clinical data of all patients with clinical stage I seminoma treated by multi-disciplinary approach between 1999 and 2008 at the Sun Yat-sen University Cancer Center were analyzed. The patients were divided Into 3 groups based on the treatment they received after orchiectomy: 30 patients treated with chemotherapy, 8 with radiotherapy, and 20 under surveillance. The prognosis of different treatment groups was evaluated. Results: Among the 58 patients with stage I seminoma, 57 were followed up successfully. The median follow-up time was 50 months (range, 8-115 months). No relapse or metastasis was seen in the chemotherapy group. One patient relapsed in the radiotherapy group. Four patients had metastasis of retroperitoneal lymph node in the surveillance group. The disease-free survival was higher in the chemotherapy group than that in the surveillance group (P = 0.005). There was no significant difference in the relapse-free survival between the surveillance group and the radiotherapy group (P = 0.364). Conclusions: In stage I seminoma, the results of chemotherapy or radiotherapy are satisfactory. But for patients under surveillance, the relapse rate is 20%. For those who are well compliant, a close follow-up Is recommended.