Two prospectively maintained oncology databases were reviewed for men with a history of testicular seminoma and cryptorchidism. The primary endpoint was the 5-year relapse-free rate.
A total of 23 men were identified, most (n = 13) had had a tumor in a scrotal location after orchiopexy. After orchiectomy, 5 men were managed with surveillance, and 18 underwent RT to a median dose of 25 Gy (range, 20–30 Gy). All the radiation fields included the para-aortic LNs, and 13 included the ipsilateral pelvic LNs. After a median follow-up of 64 months (range, 2–148), 2 patients developed a relapse. One did so 4 months into a surveillance program in the para-aortic and ipsilateral pelvic LNs, sites that would have been treated had he undergone RT. The other patient developed a relapse in the contralateral testis 46 months after having undergone RT. It is likely that the latter patient had a metachronous primary rather than a relapse; hence, the 5-year relapse-free rate was 80 % for surveillance and 100 % for RT. Both patients underwent successful salvage treatment, and all patients were disease free and alive at the last follow-up visit.
A history of cryptorchism does not appear to confer a greater risk of relapse for men with Stage I seminoma managed with radiotherapy. RT, surveillance, and adjuvant carboplatin chemotherapy are treatment options for these patients.