Table 4 Advantages and disadvantages of different management options in the treatment of stage I seminoma
Management option | Advantage | Disadvantage | |
|---|---|---|---|
Surveillance | - Excellent cancer cure rate - No treatment-related toxicity - Excellent salvage rate - Avoids overtreatment for most patients | - Frequent follow-up CT, with associated long-term risks - Anxiety related to the risk of recurrence | |
Radiation therapy | Dog-leg | - Excellent cancer cure rate - No need for routine CT - Lower recurrence rates compared with patients managed by surveillance | - Most patients are overtreated - Second malignancy risk - Cardiotoxicity - Fertility impairment |
| Â | Para-aortic | - Excellent cancer cure rate - Lower recurrence rate than patients managed by surveillance | - Frequent follow-up CT, with associated long-term risks - Second malignancy risk - Cardiotoxicity - Most patients are overtreated |
Chemotherapy | - Excellent cancer cure rate - Lower acute toxicity than radiation therapy | - Long-term survival and toxicity unknown - Frequent follow-up CT, with associated long-term risks - Most patients are overtreated | |