What is the appropriate follow-up after treatment?

S. Sharir, R. S. Foster, J. P. Donohue, M. A.S. Jewett

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Close follow-up after surgery for low volume nonseminomatous testicular cancer is important for early detection of recurrence. However, follow-up involves expense and adds to the burden of treatment. To minimize follow-up, we examined medical literature reports of results in early stage testicular cancer. Additionally, we analyzed our own data for the specific patterns of failure in stages I and II after retroperitoneal lymphadenectomy (RPL) and stage I on surveillance. We conclude that the most rigorous protocols should be reserved for stage I on surveillance and stage II on observation after RPL. Less frequent follow-up is needed for the other treatment options. For all patients, follow-up must be most intense early on, because of the high relapse rate in the first 1 to 2 years. Because there was no correlation noted between the site and timing of relapse in any group, physical examination and marker determination must be performed at every visit. In addition, where the retroperitoneum has been sterilized by RPL, chest x-ray must be performed, but computed tomography (CT) of the abdomen and pelvis is generally unnecessary. For stage I on surveillance, abdominopelvic CT is needed but the value of chest x-ray is questionable.

Original languageEnglish (US)
Pages (from-to)45-53
Number of pages9
JournalSeminars in Urologic Oncology
Volume14
Issue number1
StatePublished - Mar 22 1996
Externally publishedYes

Keywords

  • Testicular cancer
  • cancer recurrence
  • early stage
  • follow-up
  • nonseminoma
  • protocol

ASJC Scopus subject areas

  • Urology

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  • Cite this

    Sharir, S., Foster, R. S., Donohue, J. P., & Jewett, M. A. S. (1996). What is the appropriate follow-up after treatment? Seminars in Urologic Oncology, 14(1), 45-53.