Rustin, G.J., Mead, G.M., Stenning, S.P., Vasey, P.A., Aass, N., Huddart, R.A., Sokal, M.P., Joffe, J.K., Harland, S.J. and Kirk, S.J. (2007) Randomized trial of two or five computed tomography scans in the surveillance of patients with stage I nonseminomatous germ cell tumors of the testis: Medical Research Council Trial TE08, ISRCTN56475197 - The National Cancer Research Institute Testis Cancer Clinical Studies Group. Journal of Clinical Oncology, 25(11), pp. 1310-1315.
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Abstract
PURPOSE: Surveillance is a standard management approach for stage I nonseminomatous germ cell tumors (NSGCT). A randomized trial of two versus five computed tomography (CT) scans was performed to determine whether the number of scans influenced the proportion of patients relapsing with intermediate- or poor-prognosis disease at relapse. METHODS: Patients with clinical stage I NSGCT opting for surveillance were randomly assigned to chest and abdominal CT scans at either 3 and 12 or 3, 6, 9, 12, and 24 months, with all other investigations identical in the two arms. Three of five patients were allocated to the two-scan schedule. Four hundred patients were required. RESULTS: Two hundred forty-seven patients were allocated to a two-scan and 167 to five-scan policy. With a median follow-up of 40 months, 37 relapses (15%) have occurred in the two-scan arm and 33 (20%) in the five-scan arm. No patients had poor prognosis at relapse, but two (0.8%) of those relapsing in the two-scan arm had intermediate prognosis compared with 1 (0.6%) in the five-scan arm, a difference of 0.2% (90% CI, -1.2% to 1.6%). No deaths have been reported. CONCLUSION: This study can rule out with 95% probability an increase in the proportion of patients relapsing with intermediate- or poor-prognosis disease of more than 1.6% if they have two rather than five CT scans as part of their surveillance protocol. CT scans at 3 and 12 months after orchidectomy should be considered a reasonable option in low-risk patients.
Item Type: | Articles |
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Status: | Published |
Refereed: | Yes |
Glasgow Author(s) Enlighten ID: | UNSPECIFIED |
Authors: | Rustin, G.J., Mead, G.M., Stenning, S.P., Vasey, P.A., Aass, N., Huddart, R.A., Sokal, M.P., Joffe, J.K., Harland, S.J., and Kirk, S.J. |
College/School: | College of Medical Veterinary and Life Sciences |
Journal Name: | Journal of Clinical Oncology |
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