ORIGINAL ARTICLE   

Minerva Urology and Nephrology 2021 February;73(1):84-9

DOI: 10.23736/S2724-6051.19.03562-8

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

Analysis of clinical utility of abdominopelvic computed tomography in the follow-up of Stage I seminoma: a single center evaluation

Michele RIZZO ¹ ✉, Luca ONGARO ¹, Francesco CLAPS ¹, Dario GHASSEMPOUR ¹, Enrica VERZOTTI ¹, Francesca MIGLIOZZI ¹, Matteo BOLTRI ¹, Nicola PAVAN ¹, Giulio GARAFFA ², Stefano BUCCI ¹, Paolo UMARI ³, Carlo TROMBETTA ¹, Giovanni LIGUORI ¹

¹ Department of Medicine, Surgery and Health Sciences, Clinic of Urology, University of Trieste, Trieste, Italy; ² The Institute of Urology, University College London Hospitals, London, UK; ³ Department of Surgery, Clinic of Urology, University of Eastern Piedmont, Novara, Italy

BACKGROUND: Abdominopelvic computed tomography (CT) is widely used in the follow-up of seminoma patients after radical orchidectomy. The aim of this study was to evaluate the clinical utility of abdominopelvic computed tomography in the follow-up of patients with Stage I seminoma.
METHODS: The pathological reports of all patients that have undergone radical orchidectomy in our tertiary referral center between January 2002 and January 2018 have been retrospectively reviewed. All patients with Stage I seminoma and negative serum tumor markers after radical orchidectomy were included. Patients with follow-up shorter than 12 months were excluded. Surveillance records of every patient were reviewed with regard to abdominopelvic imaging.
RESULTS: Of the 133 patients who have undergone radical orchidectomy in our center, 55 had Stage I pure seminoma with normal levels of serum tumor markers after surgery. Two patients were excluded as the follow-up was inadequate. Mean follow-up was 63.2 months (IQR: 30-73). The results of 211 abdominopelvic CTs performed as part of the follow-up were reviewed. Two (3,7%) patients developed recurrence; one consisted of a scrotal lump and was diagnosed with ultrasonography (US) while the second appeared as paraaortic nodal metastasis and was diagnosed with abdominopelvic CT. The recurrence was successfully treated in both patients. A single abdominopelvic CT was useful for the detection of recurrent disease in our entire study population. No cancer specific death has been reported in the study population.
CONCLUSIONS: Follow-up schedules for Stage I seminoma expose patients to potential risks of radiation-induced tumors, emotional distress and represent a significant burden for the healthcare system. The current series suggests that a better risk adapted patient-tailored follow-up program is needed in order to avoid unnecessary investigations.

KEY WORDS: Seminoma; Tomography, X-ray computed; Recurrence; Testicular neoplasms