Treatment preferences in stage IA and IB XXXX : multicenter study of Anatolian Society of Medical Oncology.

@entity1 @entity66 @entity5 @entity3003 @entity1062 @entity4797 @entity1349
BACKGROUND: Approximately 75  % of @entity1 with @entity4797 present with stage I disease, and the probability of long-term survival approaches 100  %. However, the standard adjuvant treatment for @entity5 @entity1 remains controversial, and there is no uniform consensus in the literature. The present study was performed to evaluate treatment preference and outcomes for @entity1 with @entity1062 . MATERIALS AND METHODS: From 1997 to 2013, 282 @entity1 with histologically confirmed stage IA and IB @entity4797 who underwent orchiectomy were included. The outcomes of three management options and survivals were retrospectively analyzed. The prognostic significance of risk factors for relapse on survival was evaluated by univariate and multivariate analysis; in addition, the factors predicting relapse were also evaluated by logistic regression analysis. RESULTS: Of the 282 @entity1 with @entity5 , 130 (46.1) received adjuvant radiotherapy (RT), 80 (28.4  %) were treated with adjuvant @entity3003 , while the remaining 72 @entity1 (25.5  %) underwent surveillance. At the time of analysis, the median follow-up period of 38.5  months; relapses were observed in 16 @entity1 (22.3  %) on surveillance, in one @entity1 (1.2  %) treated with adjuvant @entity3003 and in ten @entity1 (%7.7) who received adjuvant RT. The 5-year @entity66 ( @entity66 ) rate for @entity1 who underwent surveillance was worse than those of @entity1 treated with adjuvant @entity3003 and RT (64.2 vs. 97.7 vs. 91.9  %, respectively; p  <  0.001). However, the 5-year @entity1349 ( @entity1349 ) rate for @entity1 on surveillance was similar compared with the adjuvant treatment groups (100 vs. 92.3 vs. 97.4  %, respectively; p  =  0.44). Univariate analysis showed that only the treatment approach (surveillance vs. adjuvant @entity3003 vs. adjuvant RT) for @entity66 (p  <  0.001), invasion of the rete testis (p  =  0.041) and the presence of relapse (p  <  0.001) for @entity1349 were important prognostic indicators. Multivariate analysis indicated that the treatment strategy for @entity66 (p  <  0.001, HR 0.34) was an independent prognostic factor. Furthermore, a logistic regression analysis showed that adjuvant treatment was found to be an independent factor for predicting relapse (p  =  0.004, odds ratio: 0.39). CONCLUSIONS: Our results indicate that adjuvant treatment with @entity3003 or RT is associated with improved @entity66 compared with surveillance for @entity1 with @entity1062 after orchiectomy. Moreover, the treatment strategy is an important prognostic indicator for @entity66 and a predictive factor for relapse. Although adjuvant treatment, especially @entity3003 , seems to be a suitable treatment for @entity1 with risk factors for relapse, surveillance is still feasible and the preferred management option after radical orchiectomy in @entity1 with @entity5 . More reliable predictive factors are needed to make treatment decisions.
