Stage I seminoma: Outcome of different treatment modalities and changes in patterns of care. A single institution experience

Background: The mainstay for management of stage I seminoma is high inguinal orchiec-tomy with post-orchiectomy therapeutic options including active surveillance, chemotherapy or radiation therapy. Objectives: To analyze different post-orchiectomy treatment modalities outcomes of stage I seminoma patients presented to NCI, Cairo University in the period from 2005-2019. Patients and methods: A retrospective review of all patients' records with clinical stage I seminoma who presented to our institute in the period from 2005-2019 was done. Adjuvant treatment details were extracted, and we compared overall sur-vival (OS) and disease free survival (DFS) for different modali-ties and changes in patterns of care over this period. Results: Thirty-five patients were identified with thirty three patients eligible for analysis. Median age was 35 years (range, 19-52). Fourteen patients were kept under active surveillance, eleven patients received adjuvant carboplatin and eight patients received adjuvant radiation to para-aortic chain. Five-year OS was 100% for all patients regardless post-operative approach. Five-year DFS was 100% for patients who received adjuvant chemotherapy or radiotherapy versus 93% for patients who were kept under active surveillance (p = 0.03). Conclusions: Clinical stage I seminoma is a favorable disease entity with favorable disease related outcomes regardless post-operative approach. Active surveillance is reasonable and safe given equal survival to active treatment.