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Surveillance policy for Japanese patients with stage I testicular germ cell cancer in the multi-detector computed tomography era

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Abstract

Background

The outcome of surveillance for Japanese patients with clinical stage I testicular germ cell cancer (GCC) was investigated in the multi-detector computed tomography (MDCT) era.

Methods

The medical records of 92 Japanese patients with stage I GCC, who received treatment in our institution between March 1999 and February 2013, were reviewed. As six patients requested and received prophylactic chemotherapy and two patients seriously deviated from surveillance schedule, these patients were excluded from the study. Data from a total 84 patients were analyzed,

Results

The median follow-up period following diagnosis was 5.1 years (inter-quartile range: IQR, 2.3–7.7 years). Of the 84 patients, eight (9.5 %) had a recurrence of their cancer in this observation period. Regarding histologic subtypes, the recurrence rates were five (9.3 %) of the 54 patients with seminoma and three (10 %) of the 30 patients with nonseminomatous germ cell tumor (NSGCT). All eight patients who experienced a recurrence did so within 2 years; they all underwent induction chemotherapy and remain alive at the time of writing, with no evidence of disease. Among 31 seminoma patients with a tumor more than 4 cm in size and rete testis invasion, cancer recurred in three (9.7 %) during the surveillance period. On the other hand, among the 13 patients with NSGCT and vascular invasion, three (23 %) experienced a recurrence, whereas the figure was zero for the 11 (0 %) patients without vascular invasion.

Conclusion

Fewer than 10 % of Japanese patients with stage I testicular GCC suffered a recurrence in the 5-year observation period of this study. The risk of occult disease, which will result in relapse, might be decreased in the MDCT era. All patients must be fully informed of the anticipated recurrence rate and the potential risks of exposure to chemotherapy agents.

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Abbreviations

GCC:

Germ cell cancer

NSGCT:

Nonseminomatous germ cell tumor

MDCT:

Multi-detector computed tomography

CT:

Computed tomography

AFP:

Alpha-fetoprotein

hCG:

Human chorionic gonadotropin

LDH:

Lactate dehydrogenase

BEP:

Bleomycin, etoposide, and cisplatin

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Acknowledgments

The work was partly supported by the Smoking Research Foundation, the Takeda Science Foundation, and Grants-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology, Japan.

Conflict of interest

Yuasa T. received remuneration for a lecture from Pfizer Japan (Tokyo, Japan) and Novartis Pharma Japan (Tokyo, Japan). The other authors have declared no conflict of interest.

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Authors and Affiliations

  1. Department of Urology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake, Tokyo, 135-8550, Japan

    Takeshi Yuasa, Hajime Tanaka, Shinji Urakami, Shinya Yamamoto, Yasuhisa Fujii, Hitoshi Masuda, Iwao Fukui & Junji Yonese

  2. Department of Pathology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Ariake, Tokyo, 135-8550, Japan

    Naoko Inoshita & Yuichi Ishikawa

Authors
  1. Takeshi Yuasa
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  2. Naoko Inoshita
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  3. Hajime Tanaka
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  4. Shinji Urakami
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  9. Yuichi Ishikawa
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Corresponding author

Correspondence to Takeshi Yuasa.

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Yuasa, T., Inoshita, N., Tanaka, H. et al. Surveillance policy for Japanese patients with stage I testicular germ cell cancer in the multi-detector computed tomography era. Int J Clin Oncol 20, 1198–1202 (2015). https://doi.org/10.1007/s10147-015-0828-1

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  • DOI: https://doi.org/10.1007/s10147-015-0828-1

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