NDLI: Is radiotherapy a good adjuvant strategy for men with a history of cryptorchism and stage I seminoma?

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Martin, Jarad M. Gorayski, Peter Zwahlen, Daniel Fay, Michael Keller, Jacqui Millar, Jeremy
Spatial Coverage	Victoria Queensland
Description	Country affiliation: Australia Author Affiliation: Martin JM ( Department of Radiation Oncology, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia. jarad.martin@roq.net.au)
Abstract	PURPOSE: Men with cryptorchism can have aberrant abdominopelvic lymph node (LN) drainage or a different natural history if they develop Stage I seminoma. If so, the nodal echelons for metastases will not be reliable, and adjuvant radiotherapy (RT) would not be an ideal strategy. METHODS AND MATERIALS: Two prospectively maintained oncology databases were reviewed for men with a history of testicular seminoma and cryptorchidism. The primary endpoint was the 5-year relapse-free rate. RESULTS: A total of 23 men were identified, most (n = 13) had had a tumor in a scrotal location after orchiopexy. After orchiectomy, 5 men were managed with surveillance, and 18 underwent RT to a median dose of 25 Gy (range, 20-30 Gy). All the radiation fields included the para-aortic LNs, and 13 included the ipsilateral pelvic LNs. After a median follow-up of 64 months (range, 2-148), 2 patients developed a relapse. One did so 4 months into a surveillance program in the para-aortic and ipsilateral pelvic LNs, sites that would have been treated had he undergone RT. The other patient developed a relapse in the contralateral testis 46 months after having undergone RT. It is likely that the latter patient had a metachronous primary rather than a relapse; hence, the 5-year relapse-free rate was 80% for surveillance and 100% for RT. Both patients underwent successful salvage treatment, and all patients were disease free and alive at the last follow-up visit. CONCLUSION: A history of cryptorchism does not appear to confer a greater risk of relapse for men with Stage I seminoma managed with radiotherapy. RT, surveillance, and adjuvant carboplatin chemotherapy are treatment options for these patients.
File Format	HTM / HTML
ISSN	03603016
Issue Number	1
Volume Number	76
e-ISSN	1879355X
Journal	International Journal of Radiation OncologyastBiologyastPhysics
Language	English
Publisher	Elsevier
Publisher Date	2010-01-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Radiology Cryptorchidism Complications Seminoma Radiotherapy Testicular Neoplasms Adult Pathology Surgery Databases, Factual Disease-free Survival Humans Lymphatic Metastasis Male Middle Aged Neoplasm Staging Orchiopexy Adverse Effects Queensland Radiotherapy, Adjuvant Salvage Therapy Secondary Tumor Burden Victoria Journal Article Multicenter Study
Content Type	Text
Resource Type	Article
Subject	Radiology, Nuclear Medicine and Imaging Cancer Research Radiation Oncology

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