Early testicular biopsy in males with XXXX : lack of impact on subsequent event-free survival.

@entity1 @entity154 @entity10523 @entity981 @entity5
PURPOSE: @entity1 with @entity981 ( @entity981 ) who had bulky disease ( @entity154 ) at diagnosis had the highest rate of testicular relapse (20%) of any @entity981 subgroup on previous @entity1 's @entity5 Group (CCG) studies in the late 1980s. To limit curative, but sterilizing, testicular irradiation to those with @entity10523 , testicular biopsies were performed to detect occult @entity10523 within the first 6 months of treatment. Testicular irradiation then was provided to those with occult disease to increase disease-free survival. Identification of those with occult disease was believed to be a factor that would influence ultimate survival in such @entity1 in that era. @entity1 AND METHODS: One hundred ninety-nine @entity1 had bilateral testicular wedge biopsies performed during the first maintenance therapy phase of the four different chemotherapy regimens. @entity1 with positive biopsy results were treated with testicular irradiation and continued on therapy. RESULTS: Eleven of 199 biopsy results (5.5%) were judged positive. @entity1 with positive biopsy results given testicular radiation had a 45% subsequent adverse event rate, compared with 36% for those with a negative biopsy results (P = 0.4). The survival rates for the two groups were similar. The low rate of positive biopsy specimens resulted in discontinuation of the procedure before closure of the study. CONCLUSION: Positive testicular biopsy results early in remission identified @entity1 at a slightly higher risk of subsequent adverse events but did not influence survival. However, because negative biopsy results (94.5%) did not alter the prescribed treatment, the small number of positive biopsy results did not warrant undertaking the procedure in most male @entity1 with @entity981 , and this procedure was abandoned.
