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Volume 15, Issue 4 (July 2013) 15, 558–563; 10.1038/aja.2013.16

Clinical outcomes in patients with stage I non-seminomatous germ cell cancer

Zhao-Jie Lv1,2,*, Song Wu1,3,4,*, Pei Dong3, Kai Yao3, Yin-Yin He5, Yao-Ting Gui5, Fang-Jian Zhou3, Zhuo-Wei Liu3 and Zhi-Ming Cai1,5

1 Shenzhen Second People's Hospital, the First Affiliated Hospital of Shenzhen University, Shenzhen 518036, China
2 Anhui Medical University, Hefei 230032, China
3 Department of Urology, Sun Yat-Sen University Cancer Centre, Guangzhou 510060, China
4 Institute of Immunology, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou 510060, China
5 Institute of Urology, Shenzhen PKU-HKUST Medical Centre, Shenzhen 518036, China

* These authors contributed equally to the work.

Correspondence: Dr ZM Cai, (caizhiming2000@yahoo.com); Dr ZW Liu, (liuzhw@sysucc.org.cn)

Received 21 November 2012; Revised 3 January 2013; Accepted 26 January 2013; Advance online publication 20 May 2013


This study assesses the long-term outcomes in Han Chinese patients with clinical stage I non-seminomatous germ cell testicular cancer (CSI NSGCT) treated with surveillance, retroperitoneal lymph node dissection (RPLND) and adjuvant chemotherapy. We retrospectively evaluated 89 patients with a mean age of 26.5 years. After orchiectomy, 37 patients were treated with surveillance, 34 underwent RPLND and 18 were managed with chemotherapy. The overall survival rate, the recurrence-free survival rate and the risk factors were evaluated. The median follow-up length was 92 months (range: 6–149 months). Thirteen of the 89 patients (14.6%) had relapses, and one died by the evaluation date. The overall survival rate was 98.9%. The cumulative 4-year recurrence-free rates were 80.2%, 92.0% and 100% for the surveillance, RPLND and chemotherapy groups, respectively. The disease-free period tended to be briefer in patients with a history of cryptorchidism and those with stage Is. Therefore, surveillance, RPLND and adjuvant chemotherapy might be reliable strategies in compliant patients with CSI NSGCT. Surveillance should be recommended for patients with the lowest recurrence rate, especially those without lymphovascular invasion. This study might aid the establishment of a standard therapy for CSI NSGCT in China.

Keywords: chemotherapy; clinical stage I non-seminomatous germ cell testicular cancer (CSI NSGCT); outcome; retroperitoneal lymph node dissection (RPLND); surveillance; treatment protocols

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Asian Journal of Andrology CN 31-1795/R ISSN 1008-682X  Copyright © 2023  Shanghai Materia Medica, Chinese Academy of Sciences.  All rights reserved.