Retrospective review of patients with a diagnosis of testicular germ cell tumor seen in Waterford Regional Hospital, Ireland, in a 5.5-year period.

Abstract

e15111 Background: Testicular germ cell tumours (GCTs) account for approx 95% of testicular cancers. GCTs can be divided into 2 main groups, seminomas and nonseminomas. The majority of men with testicular cancer are long-term survivors. Following treatment, these men require oncologic surveillance. The purpose of this study was to assess adherence to NCCN guidelines for follow up of patients on surveillance, following chemotherapy, or radiotherapy. Methods: During the period September 2004 to March 2010, 39 patients with a diagnosis of testicular carcinoma were followed up in clinic in Waterford Regional Hospital with tumour markers, chest X-ray, and computed tomography. Results: The mean age at diagnosis of testicular carcinoma was 40 years (18-47 years). 2 patients died during follow up, 1 in circumstances unrelated to diagnosis while in complete remission and 1, NSGCT, due to progressive disease. 3 patients defaulted to follow up and 1 patient’s follow up was in another institution. 3 patients relapsed during surveillance, 2 with NSGCT and 1 with a mixed diagnosis. Adherence to NCCN guidelines was achieved in 12 (36%) of all documented cases with full adherence being noted from August 2009 to date. Conclusions: NCCN practice guidelines are available for follow up of patients diagnosed with testicular carcinoma with the purpose being to detect recurrence. Adherence in Waterford Regional Hospital was achieved in the first year of follow-up with decreasing adherence noted in subsequent years. Outline of treatment. Subtypes Number (%) Treatment Number (%) Seminoma 15 (38%) Unknown Orchidectomy and surveillance Orchidectomy and radiotherapy Orchidectomy and chemotherapy Orchidectomy and chemotherapy and RPLND 1 (6.66%) 2 (13.33%) 8 (53.3%) 3 (20%) 1 (6.66%) NSGCT 16 (41%) No treatment Orchidectomy Orchidectomy and surveillance Orchidectomy and chemotherapy Orchidectomy and chemotherapy and RPLND 1 (6.25%) 1 (6.25%) 5 (35.5%) 7 (43.75%) 2 (12.5%) Mixed 8 (21%) Orchidectomy Orchidectomy and surveillance Orchidectomy and chemotherapy Orchidectomy and chemotherapy and RPLND 2 (25%) 2 (25%) 2 (25%) 2 (25%) Abbreviation: RPLND, retroperitoneal lymph node dissection.