Purpose: To describe the uptake and use of surveillance andirradiation in stage I seminoma post-orchiectomy in Ontario and to evaluate theimpact of these management strategies on patient outcomes.
Background: Testicular cancer is the most common cancer in menbetween the ages of 20 and 44 (1). About half of testicular cancers areseminomas (2). Overall 85% of seminoma patients present with stage I disease with10-year survival over 99%. Adjuvant radiation therapy once constituted thestandard of care but surveillance as a post-orchiectomy management strategy isnow preferred in Ontario (3). Treatment with radiation results in importantlong-term toxicities (2). The actual management patterns and the effect ofthese patterns on seminoma patient outcomes is unknown. This will be the firstphase IV study to describe the management of stage I seminoma and to evaluateit’s effect on patient outcomes.
Methods: This is a retrospective, population based cohort studyof seminoma patients in Ontario. Cases of seminoma are identified through theOntario Cancer Registry and linked with patient data from the CanadianInstitute of Health Information and Ontario radiotherapy data. An instrumentalvariable approach will be taken with time and location of treatment as theinstruments. Mantel-Haensel Chi-Squared tests, Student’s T-test, and Log ranktests will be used to find differences in patient characteristics, morbidity andsurvival. The Kaplan-Meier method will be used to model overall survival.
Results and Conclusions:Pending data analysis.
References:
1. Warde P, Srugeon J,Gospodarowicz M. Testicular Cancer. In: Gunderson L, Tepper J, eds. Clinicalradiation oncology. Philadelphia: Chruchill Livingstone; 2000: 844-862.
2. Nichols CR, Hung A, Corless CL, Foster RS, Roth BJ, Einhorn LH.Testis cancer. In: Kufe DW, Frei III E, Holland JF, Weichselbaum RR, PollockRE, Bast Jr RC, Hong WK, Hait WN, eds. Holland-Frei cancer medicine – 7^thEd.[e-book], Columbia: BC Decker; 2006 [cited 2008 Mar 17]: ch. 99. Availablefrom: Stat!Ref.
3. Chung P, Mayhew LA, Warde P, Winquist E, Lukka H et al. Management of stage I seminoma: Guidelinerecommendations. Cancer Care Ontario, Evidence-Based Series #3-18: Section1; Report date: 30 Jan 2008
