[Risk-guided after-care of testicular tumor]

Results in 503 patients with germ cell testicular tumors treated between 1982 and 1992 were analyzed. A follow-up program for germ cell tumors is presented which is related to the individual risk of tumor relapse. The overall relapse rate was 7%, of which 82% had recurrent tumor within 1 year after treatment. A low risk of relapse (3-5%) is seen in patients with seminoma stage I and radiation and, usually, in early-stage patients treated with polychemotherapy. A moderate risk of relapse (6-11%) is observed in patients with non-seminoma stage I and lymphadenectomy without chemotherapy. Seminoma without radiation and non-seminoma without lymphadenectomy in clinical stage I, non-seminoma stage IIa and IIb without adjuvant chemotherapy after lymphadenectomy, and primary high tumor mass present a high risk of relapse (> 11%). Tumor recurrence is localized mainly in lung and retroperitoneum. Most important in the follow-up are tumor marker and chest X-ray. During the first year examinations should take place every 3 months in the low-risk group and every 2 months in the moderate and high risk group. Computer tomography is only required in high-risk patients. Usually a 3-year follow-up is sufficient.