You have accessJournal of UrologySexual Function/Dysfunction: Penis/Testis/Urethra: Benign Disease & Malignant Disease I1 Apr 2018MP37-06 IS SURVEILLANCE WITHOUT IMMEDIATE TREATMENT AN OPTION FOR NEWLY DIAGNOSED TESTICULAR GERM-CELL CANCER PATIENTS WITH BORDERLINE SIZE RETROPERITONEAL LYMPH NODES ON COMPUTED TOMOGRAPHY SCAN? Nadav Milk, Ilan Leibovitch, Daniel Keizman, Hadas Dresler, and Itay Sternberg Nadav MilkNadav Milk More articles by this author , Ilan LeibovitchIlan Leibovitch More articles by this author , Daniel KeizmanDaniel Keizman More articles by this author , Hadas DreslerHadas Dresler More articles by this author , and Itay SternbergItay Sternberg More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1212AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The AJCC TNM Staging System for Testicular Cancer (TC) does not set a minimal diameter to define positive lymph nodes (LN) on computed tomography scan. It is common to refer to LN ≥ 1 cm in diameter as positive, even though benign LN in the borderline size of 1-1.5cm are common. Our goal is to describe the outcome of TC patients with borderline size retroperitoneal LN of undetermined significance managed initially with surveillance. METHODS We retrospectively reviewed the medical records of all TC patients treated at our institution during 2006-2016. Demographic, clinical, laboratory, imaging, pathological, treatment and surveillance data were obtained. RESULTS Of a total of 109 TC patients, 24 patients (22.2%) with borderline size LN were assigned to an active surveillance protocol by our tumor board. Median age at the time of orchiectomy was 37.2 years (IQR, 23.9-40.5). With a median follow-up of 4.2 years (IQR 1.7-6.7), overall survival rate in the group was 100%. Nine of 24 patients (37.5%) relapsed and were treated within a median of 4.9 months (IQR 2.2-5.5). Median follow-up for 16 patients who did not relapse was 3.8 years (IQR 1.6-5.4). Relapse-free survival was 71% (95% CI 49-87), and 62% (95% CI 41-80) at one and two years, respectively.The median LN diameter at the time of diagnosis was 11 mm (IQR 9-12, mean 10.3). LN diameter was not associated with likelihood of relapse (p = 0.43). Orchiectomy pathology included pure seminoma in 17/24 (71%), and a nonseminomatous tumor in 7/24 (29%). Tumor type was not associated with likelihood of relapse (p = 0.63).Patients who relapsed during follow-up were significantly younger at the time of TC diagnosis than patients who did not relapse (Median age 34 years [IQR 22.4-37.3] and 40 years [IQR 36.1-47.9] respectively, p=0.025). CONCLUSIONS Surveillance alone for TC patients with borderline size LN of undetermined significance at diagnosis is a possible option and may help avoid overtreatment in 60% of these patients. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e493 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Nadav Milk More articles by this author Ilan Leibovitch More articles by this author Daniel Keizman More articles by this author Hadas Dresler More articles by this author Itay Sternberg More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...