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Randomized trial of two or five computed tomography scans in the surveillance of patients with stage I nonseminomatous germ cell tumors of the testis: Medical Research Council Trial TE08, ISRCTN56475197 - The National Cancer Research Institute Testis CancRandomized trial of two or five computed tomography scans in the surveillance of patients with stage I nonseminomatous germ cell tumors of the testis: Medical Research Council Trial TE08, ISRCTN56475197 - The National Cancer Research Institute Testis Cancer Clinical Studies Group

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Rustin, G. J., Mead, G. M., Stenning, S. P., Vasey, P. A., Aass, N., Huddart, R. A., Sokal, M. P., Joffe, J. K., Harland, S. J., Kirk, S. J. (2007) Randomized trial of two or five computed tomography scans in the surveillance of patients with stage I nonseminomatous germ cell tumors of the testis: Medical Research Council Trial TE08, ISRCTN56475197 - The National Cancer Research Institute Testis CancRandomized trial of two or five computed tomography scans in the surveillance of patients with stage I nonseminomatous germ cell tumors of the testis: Medical Research Council Trial TE08, ISRCTN56475197 - The National Cancer Research Institute Testis Cancer Clinical Studies Group. JOURNAL OF CLINICAL ONCOLOGY, 25 (11). pp. 1310-1315. ISSN 0732-183X

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Abstract

PURPOSE: Surveillance is a standard management approach for stage I nonseminomatous germ cell tumors (NSGCT). A randomized trial of two versus five computed tomography (CT) scans was performed to determine whether the number of scans influenced the proportion of patients relapsing with intermediate- or poor-prognosis disease at relapse. METHODS: Patients with clinical stage I NSGCT opting for surveillance were randomly assigned to chest and abdominal CT scans at either 3 and 12 or 3, 6, 9, 12, and 24 months, with all other investigations identical in the two arms. Three of five patients were allocated to the two-scan schedule. Four hundred patients were required. RESULTS: Two hundred forty-seven patients were allocated to a two-scan and 167 to five-scan policy. With a median follow-up of 40 months, 37 relapses (15%) have occurred in the two-scan arm and 33 (20%) in the five-scan arm. No patients had poor prognosis at relapse, but two (0.8%) of those relapsing in the two-scan arm had intermediate prognosis compared with 1 (0.6%) in the five-scan arm, a difference of 0.2% (90% CI, -1.2% to 1.6%). No deaths have been reported. CONCLUSION: This study can rule out with 95% probability an increase in the proportion of patients relapsing with intermediate- or poor-prognosis disease of more than 1.6% if they have two rather than five CT scans as part of their surveillance protocol. CT scans at 3 and 12 months after orchidectomy should be considered a reasonable option in low-risk patients.

Item Type: Article
Authors (ICR Faculty only): Huddart, Robert
All Authors: Rustin, G. J., Mead, G. M., Stenning, S. P., Vasey, P. A., Aass, N., Huddart, R. A., Sokal, M. P., Joffe, J. K., Harland, S. J., Kirk, S. J.
Uncontrolled Keywords: Follow-up; management; risk; radiation; relapse; thorax; size
Research teams: ICR divisions > Radiotherapy and Imaging > Clinical Academic Radiotherapy (Huddart)
Depositing User: EPrints Services
Date Deposited: 13 Aug 2007 14:48
Last Modified: 10 Feb 2010 11:49
URI: http://publications.icr.ac.uk/id/eprint/3990

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