Localized testicular germ cell tumor surveillance: A Delphi consensus study.

Authors

null

Angélique DA Silva

Department of Medical Oncology, Centre Francois Baclesse, Caen, France

Angélique DA Silva , Aude Flechon , Stephane Culine , François Planchamp , Thibaut Murez , Arnaud Mejean , David Pasquier , Karim Fizazi , Florence Joly

Organizations

Department of Medical Oncology, Centre Francois Baclesse, Caen, France, Department of Medical Oncology, Centre Léon Bérard, Lyon, France, Department of Medical Oncology, Hospital Saint-Louis, Paris, France, Clinical Research Unit, Institut Bergonié, Bordeaux, France, Department of Urology, Hôpital Lapeyronie, Montpellier, France, Department of Urology, Hôpital Européen Georges-Pompidou - Paris Descartes University, Paris, France, Academic Department of Radiation Oncology,Centre Oscar Lambret, Lille, France, Institut Gustave Roussy and University of Paris Sud, Villejuif, France, Department of Medical Oncology, Centre François Baclesse, Caen, France

Research Funding

No funding received
None

Background: Stage I testicular germ cell tumor (TGCT) has excellent cure rates and surveillance is fully included in patient’s management, particularly during the first years of follow-up. Surveillance guidelines differ between the scientific societies, with different recommendations concerning clinical and imaging frequency de-escalation and long term follow-up. We evaluated surveillance practice and schedules followed by French specialists and set up a DELPHI method to obtain a consensual surveillance program with an optimal schedule for patients with localized TGCT. Methods: An online survey on surveillance practice of stage I TGCT based on clinical-cases was conducted among urologists, radiotherapists and oncologists. Results were compared to AFU, ESMO and EAU guidelines. Then a panel of experts assessed surveillance proposals following a formal consensus method (DELPHI method). Statements were drafted after analysis of the previous survey and systematic literature review, with 2 successive rounds to reach a consensus. Results: Survey and DELPHI method were conducted between July 2018 and May 2019. 61 participated to the survey (69% oncologists, 15% urologists, 16% radiotherapists). About 65% of practitioners followed clinico-biological guidelines concerning 1 to 5 years of follow-up, only 25% discontinued surveillance after the 5th year, as recommended. No physician followed the ESMO guidelines of de-escalation chest imaging. A panel of 32 experts (78% oncologists, 16% urologists, 6% radiotherapists) was asked about 38 statements. Consensus was reached for 26 statements concerning clinico-biological surveillance modalities and end of surveillance after the 5th year of follow-up. For seminoma, abdominal ultrasound was proposed as an option to the abdominopelvic (AP) scan for the 4th year of follow-up. No consensus was reached regarding de-escalation of chest imaging. Conclusions: The survey proved that French TGCT specialists do not follow current guidelines. With DELPHI method, a consensus was obtained for frequency of clinico-biological surveillance, discontinuation of surveillance after the 5th year and discontinuation of AP scan on the 4th year of follow-up for seminoma. Questions remains concerning type and frequency of chest imaging.

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Abstract Details

Meeting

2020 ASCO Virtual Scientific Program

Session Type

Publication Only

Session Title

Publication Only: Genitourinary Cancer—Kidney and Bladder

Track

Genitourinary Cancer—Kidney and Bladder

Sub Track

Germ Cell/Testicular

Citation

J Clin Oncol 38: 2020 (suppl; abstr e17060)

DOI

10.1200/JCO.2020.38.15_suppl.e17060

Abstract #

e17060

Abstract Disclosures

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