Mortensen, MS, Lauritsen, J, Kier, MGG et al. (7 more authors) (2016) Late Relapses in Stage I Testicular Cancer Patients on Surveillance. European Urology, 70 (2). pp. 365-371. ISSN 0302-2838
Abstract
Background: Comprehensive data on late relapse (LR) and very LR (VLR) in patients with clinical stage I (CS-1) testicular cancer followed on surveillance are missing. These data are essential for planning optimal follow-up. Objective: Assess incidence and outcome of LR (>2 yr) and VLR (>5 yr) in a large cohort of CS-1 surveillance patients, and examine differences in the clinical characteristics of patients with early relapse (ER), LR, and VLR. Design, setting, and participants: CS-1 surveillance patients diagnosed between 1984 and 2007 were identified from the retrospective Danish Testicular Cancer (DaTeCa) database. Outcome measurements and statistical analysis: We estimated survival and relapse probabilities and compared the results using log-rank tests and Cox regression analyses. We compared differences in patient characteristics by using χ2, Fisher exact, and Mann-Whitney tests. Results and limitations: Our study included 3366 (2000 seminoma and 1366 nonseminoma) patients. Median follow-up was 15 yr. Five-year conditional risk of LR was 5.0% and 2.1% for seminoma and nonseminoma patients, respectively. There were no significant differences in disease-specific or overall survival when comparing the LR(VLR) and ER patients by log-rank, but Cox regression adjusted for age showed a significant effect of time to relapse on survival for seminoma patients. Apart from significantly more ER nonseminoma patients with elevated human chorionic gonadotropin at relapse, there were no significant differences in patient characteristics at orchiectomy or relapse. Limitations include retrospective design and exclusion of patients who had been offered adjuvant therapy. Conclusions: The risk of VLR is minimal, and the patients carry a good prognosis. Patient characteristics of CS-1 surveillance patients with LR(VLR) do not differ significantly from patients with ER. Patient summary: We compared stage I testicular cancer surveillance patients with early relapse (ER) versus late relapse (LR; >2 yr). LR patients as a group did no worse than ER patients, although increased time to relapse was negatively associated with survival for seminoma patients.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2016, European Association of Urology. Published by Elsevier B.V. All rights reserved. This is an author produced version of a paper published in European Urology. Uploaded in accordance with the publisher's self-archiving policy.2016 European Association of Urology. Published by Elsevier B.V. All rights reserved. |
Keywords: | Late relapse; Stage I germ cell cancer; Surveillance; Seminoma; Nonseminoma |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Cancer and Pathology (LICAP) |
Depositing User: | Symplectic Publications |
Date Deposited: | 02 Mar 2017 14:00 |
Last Modified: | 12 Apr 2017 03:18 |
Status: | Published |
Publisher: | Elsevier |
Identification Number: | 10.1016/j.eururo.2016.03.016 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:112621 |