CT Followup for Testicular Cancer – pro

There is a difference of opinion between European and American guidelines regarding routine CT scanning for surveillance. ESMO recommends clinical review, chest X-ray and tumor markers monthly for 2 year, 2 monthly for the 2nd year, then 6monthly to 5 years and then annually and CT scans only as clinically indicated. Similar recommendation was made in the Netherlands. On the other hand, in the USA the NCCN (p.15)recommends abdomino- pelvic CT every 2-3 months in the first year and 6-12 months in the 2nd years. Thereafter it is every 12 months until year 6+ when it is 12-24mo. This is for non-seminoma. For seminoma it is somewhat different but similar (TEST-12). It does not recomend routine chest CT scans.

After RPLND, NCCN accepts chest CT as clinically indicated.

PET is not recommended for surveillance by NCCN or any other guideline to my knowledge.

Albers P, Albrecht W, Algaba F, et al. (2005) Guidelines on testicular cancer. Eur Urol 48:6885–894.

Schmoll HJ, Souchon R, Krege S, et al. (2004) European consensus on diagnosis and treatment of germ cell cancer: a report of the European Germ Cell Cancer Consensus Group EGCCCG). Ann Oncol 15:91377–1399.

Albers P, Albrecht W, Algaba F, Bokemeyer C, Cohn-Cedermark G, Horwich A, Laguna MP. Guidelines on testicular cancer. Arnhem, The Netherlands: European Association of Urology (EAU); 2008 Mar. 54 p. [35 references]

NCCN, testicular cancer 2012

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