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

DOI: 10.23736/S2724-6051.19.03562-8


lingua: Inglese

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

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