UNASSIGNED: 4596 Background: Controversy exists regarding the optimal management of @entity5 . This analysis defines the Kaiser experience over a 20-year period. Options after orchiectomy were observation vs. adjuvant radiation or chemotherapy. METHODS: This is a retrospective study of 502 @entity1 diagnosed with @entity5 from 1990-2010. All @entity1 underwent orchiectomy. Outcomes examined were @entity4557 ( @entity4557 ), @entity1349 ( @entity1349 ), and @entity1349 ( @entity1349 ). RESULTS: Of the 502 @entity1 , 329 were treated with @entity138 (113 to a pelvic/paraaortic field, 202 to a paraaortic field, and 14 to other fields), 79 had chemotherapy (33 had @entity3003 x 1, 36 had carboplatin x 2, and 10 had other agents), and 94 were observed. Among the @entity138 @entity1 (median follow-up 7.5 y), there were 8 relapses and 12 @entity204 , of which 2 were @entity204 from @entity4797 . @entity4557 was 97.6% and 97.2% at 2 and 5 years. Median time to relapse was 13.1 mos. Of the @entity1 who relapsed, 6 were successfully salvaged with chemotherapy; 2 died of disease. @entity1349 was 99.6% and 98.0% and @entity1349 was 99.6% and 99.3% at 2 and 5 years. @entity204 from disease occurred at a median of 22.4 mos. Among the chemotherapy @entity1 (median follow-up 2.6 y), there was 1 relapse at 14 mos and no @entity204 . Two-year @entity4557 was 98.3% and @entity1349 and @entity1349 were 100%. The @entity1 who relapsed was successfully salvaged with @entity12962 . Among the observation @entity1 (median follow-up 5.2 y), there were 11 relapses, 3 @entity204 , and no @entity204 from @entity4797 . @entity4557 was 89.2%, @entity1349 was 98.8%, and @entity1349 was 100% at 2 and 5 years. Median time to relapse was 11.5 mos. Of the @entity1 who relapsed, 6 were salvaged with @entity138 and 4 with chemotherapy; all were NED at last follow-up. One @entity1 is currently undergoing chemotherapy. @entity4557 , @entity1349 , and @entity1349 were compared via the log-rank test. There was no difference in @entity1349 or @entity1349 among the groups. @entity4557 was lower among observation @entity1 (p < 0.001). CONCLUSIONS: Consistent with published trials, our data show that adjuvant radiation and chemotherapy yield similar outcomes in the management of @entity5 . Observation is a viable option that allows @entity1 to avoid the toxicities of therapy. Our data confirm that while observation results in a lower @entity4557 , @entity1 who relapse can be salvaged, and @entity1349 and @entity1349 are not affected.

Observation versus adjuvant radiation or chemotherapy in the management of XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity12962 :: ('CHEBI:34567', 'Chemical') :: ['BEP'] @entity4557 :: ('MESH:D012008', 'Disease') :: ['RFS', 'relapse-free survival'] @entity138 :: ('MESH:C563738', 'Disease') :: ['RT'] @entity5 :: ('MESH:D009369', 'Disease') :: ['stage I seminoma'] @entity3003 :: ('MESH:D016190', 'Chemical') :: ['carboplatin'] @entity4797 :: ('MESH:D018239', 'Disease') :: ['seminoma'] @entity204 :: ('MESH:D003643', 'Disease') :: ['Death', 'deaths'] @entity1349 :: ('MESH:D011475', 'Disease') :: ['OS', 'CSS', 'cause-specific survival', 'overall survival']
@entity5 :: (MESH:D009369,Disease) :: ['stage I seminoma']
