Management of Stage I seminoma

♦ 20% seminomas recur after orchidectomy

♦ 90% of relapse is in para-aortic nodes

♦ Radiotherapy to para-aortic/pelvic nodes reduces relapse to 4%

♦ Current trials for chemotherapy in Stage 1 seminoma

♦ Radiotherapy to para-aortic nodes in all stages (T10-S1)

♦ Risk factors for pelvic node involvement —previous inguino-scrotal surgery

—maldescent

♦ If risk factor is present give pelvic node radiotherapy

♦ IVU to identify kidney position —limit radiation to kidney

—horseshoe kidney is contraindication to radiotherapy

♦ Standard dose of radiotherapy is 30 Gy in 15 fractions over 3 weeks

♦ Side-effects of radiotherapy—nausea

—tiredness

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