Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/33115
Title: Patterns of Relapse in Australian Patients With Clinical Stage 1 Testicular Cancer: Utility of the Australian and New Zealand Urogenital and Prostate Cancer Trials Group Surveillance Recommendations.
Austin Authors: Conduit, Ciara;Lewin, Jeremy;Weickhardt, Andrew J ;Lynam, James;Wong, Shirley;Grimison, Peter;Sengupta, Shomik ;Pranavan, Ganes;Parnis, Francis;Bastick, Patricia;Campbell, David;Hansen, Aaron R;Leonard, Matt;McJannett, Margaret;Stockler, Martin R;Gibbs, Peter;Toner, Guy;Davis, Ian D;Tran, Ben;Kuchel, Anna
Affiliation: Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia
Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia
Department of Medical Oncology, Calvary Mater Newcastle, Waratah, NSW, Australia
Department of Medical Oncology, Western Health, Footscray, VIC, Australia.
Department of Medical Oncology, Chris O'Brien Lifehouse, Camperdown, NSW, Australia
Department of Urology, Eastern Health, Box Hill, VIC, Australia.
Department of Medical Oncology, The Canberra Hospital, Garran, ACT, Australia.
Department of Medical Oncology, Icon Cancer Centre, Adelaide, SA, Australia.
Southside Cancer Care Centre, Kogarah, NSW, Australia
Department of Medical Oncology, Barwon Health, Geelong, VIC, Australia.
Department of Medical Oncology, Princess Alexandra Hospital, Woolloongabba, QLD, Australia
Olivia Newton-John Cancer Research Institute
University of Newcastle, Callaghan, NSW, Australia.
NHMRC Clinical Trials Centre, University of Sydney, Camperdown, NSW, Australia
Department of Medical Oncology, St George/Sutherland Hospital, Caringbah, NSW, Australia.
University of Sydney, Camperdown, NSW, Australia.
Monash University Eastern Health Clinical School, Box Hill, VIC, Australia
Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, Australia.
Department of Medical Oncology, Royal Brisbane and Women's Hospital, Herston, QLD, Australia.
Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, Australia
ONTrac at Peter Mac, Victorian Adolescent and Young Adult Cancer Service, Melbourne, VIC, Australia.
University of Queensland, Brisbane, QLD, Australia.
La Trobe University, Melbourne, VIC, Australia
Department of Medical Oncology, Concord Repatriation General Hospital, Concord, NSW, Australia.
Department of Medical Oncology, Eastern Health, Box Hill, VIC, Australia.
Medical Oncology
Issue Date: Nov-2023
Date: 2023
Publication information: JCO Oncology Practice 2023-11; 19(11)
Abstract: International guidelines advocate for active surveillance as the preferred treatment strategy for patients with stage 1 testicular cancer after orchidectomy although a personalized discussion is required. We conducted an analysis of individuals registered in iTestis, Australia's testicular cancer registry, to describe the patterns of relapse and outcomes of patients treated in Australia where the Australian and New Zealand Urogenital and Prostate Cancer Trials Group Surveillance Recommendations are widely adopted. A total of 650 individuals diagnosed between 2000 and 2020 were included, 63% (411 of 650) seminoma and 37% (239 of 650) nonseminoma. The median age was 34 years (range 14-74). 26% (106 of 411) with seminoma and 15% (36 of 239) nonseminoma received adjuvant chemotherapy. After a median follow-up of 43 months (range 0-267) postorchidectomy, relapse occurred in 10% (43 of 411) of seminoma and 18% (43 of 239) of nonseminoma. The two-year relapse-free survival was 92% (95% CI, 89 to 95) and 82% (95% CI, 78 to 87) in seminoma and nonseminoma, respectively. All relapses (86 of 86) were detected at a routine surveillance visit; 98% (85 of 86) were asymptomatic and detected solely through imaging (62 of 86, 72%), tumor markers (6 of 86, 7%), or a combination (17 of 86, 20%). The most common relapse site was isolated retroperitoneal lymphadenopathy (53 of 86, 62%). No nonpulmonary visceral metastases occurred. At relapse, 98% (84 of 86) had International Germ Cell Cancer Collaborative Group (IGCCCG) good prognosis; 2 of 86 intermediate prognosis (both nonseminoma). No deaths occurred. In our cohort of stage 1 testicular cancer, where national surveillance recommendations have been widely adopted, recurrences were detected at routine surveillance visits and, almost exclusively, asymptomatic with IGCCCG good-prognosis disease. This provides reassurance that active surveillance is safe.
URI: https://ahro.austin.org.au/austinjspui/handle/1/33115
DOI: 10.1200/OP.23.00191
ORCID: 0000-0001-5258-4130
0000-0002-4305-117X
0000-0002-6482-9681
0000-0002-6742-820X
0000-0002-2653-1657
0000-0003-3357-1216
0000-0002-2363-8707
0009-0000-1640-8068
0000-0003-3793-8724
0000-0003-1423-4484
0000-0001-9873-3592
0000-0002-9066-8244
0000-0001-8580-2974
Journal: JCO Oncology Practice
Start page: OP2300191
PubMed URL: 37327464
ISSN: 2688-1535
Type: Journal Article
Appears in Collections:Journal articles

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