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Orchidectomy for clinical stage I testicular cancer: progress report of the Royal Marsden Hospital Study.

Between January 1979 and June 1984, 133 patients with clinical Stage I testicular germ-cell tumours have been watched without further treatment after orchidectomy and managed with chemotherapy in the event of relapse. The rationale for this approach has been set out elsewhere (Peckham et al. 1982, 1983a). Surveillance is rendered feasible by the efficacy of chemotherapy, particularly in patients with small-volume metastases. The detection of limited disease is aided by CT scanning and measurement of serum alphafetoprotein (AFP) and human chorionic gonadotrophin (HCG) levels. Prior to 1979 radiation therapy was employed in Stage I non-seminoma patients. This was discontinued when the surveillance study was initiated. More recently a similar approach has been adopted in seminoma.