Surveillance for non-seminomatous testicular cancer – pro
Acccording to NCCN, CT scans are “as clinically indicated”. With normal scans and Alpha-fetoprotein and having had treatment is 2011 and clear since then, there is no clinical indication and no clinical necessity, for the following Plan’s criteria: 1
“be necessary, appropriate, and consistent with the diagnosis and treatment of your condition;
be in accordance with the standards of good medical practice;
be consistent with professionally recognized national standards of quality in the United States”
ESMO guidelines are less emphatic but do not recommend CT scans in most situations. 2
“Early detection and treatment of relapse represents the primary objective of follow-up visits during the first 510 years. Recommendations for the follow-up schedule need to be adapted according to national and institutional requirements. Many follow-up recommendations that have been published most likely expose TGCT survivors to unnecessary radiation, increasing the risk of a radiation-induced second cancer. Replacing CT by MRI scan would reduce this risk, but is not considered feasible for the majority of European countries. However, effort should be made to reduce the frequency of CT scans and limit their overall number. ”
1.NCCN, Non-seminoma, TEST-B, 3. 2015
2,J. Oldenburg et al, Testicular seminoma and non-seminoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol (2013) 24 (suppl 6): vi125-vi132.