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dc.contributor.authorJoffe, JK
dc.contributor.authorCafferty, FH
dc.contributor.authorMurphy, L
dc.contributor.authorRustin, GJS
dc.contributor.authorSohaib, SA
dc.contributor.authorGabe, R
dc.contributor.authorStenning, SP
dc.contributor.authorJames, E
dc.contributor.authorNoor, D
dc.contributor.authorWade, S
dc.contributor.authorSchiavone, F
dc.contributor.authorSwift, S
dc.contributor.authorDunwoodie, E
dc.contributor.authorHall, M
dc.contributor.authorSharma, A
dc.contributor.authorBraybrooke, J
dc.contributor.authorShamash, J
dc.contributor.authorLogue, J
dc.contributor.authorTaylor, HH
dc.contributor.authorHennig, I
dc.contributor.authorWhite, J
dc.contributor.authorRudman, S
dc.contributor.authorWorlding, J
dc.contributor.authorBloomfield, D
dc.contributor.authorFaust, G
dc.contributor.authorGlen, H
dc.contributor.authorJones, R
dc.contributor.authorSeckl, M
dc.contributor.authorMacDonald, G
dc.contributor.authorSreenivasan, T
dc.contributor.authorKumar, S
dc.contributor.authorProtheroe, A
dc.contributor.authorVenkitaraman, R
dc.contributor.authorMazhar, D
dc.contributor.authorCoyle, V
dc.contributor.authorHighley, M
dc.contributor.authorGeldart, T
dc.contributor.authorLaing, R
dc.contributor.authorKaplan, RS
dc.contributor.authorHuddart, RA
dc.contributor.authorTRISST Trial Management Group and Investigators
dc.coverage.spatialUnited States
dc.date.accessioned2022-07-28T10:20:46Z
dc.date.available2022-07-28T10:20:46Z
dc.date.issued2022-03-17
dc.identifier.citationJournal of Clinical Oncology, 2022, pp. JCO2101199 -en_US
dc.identifier.issn0732-183X
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/5249
dc.identifier.eissn1527-7755
dc.identifier.eissn1527-7755
dc.identifier.eissn1527-7755
dc.identifier.eissn1527-7755
dc.identifier.doi10.1200/JCO.21.01199
dc.identifier.doi10.1200/JCO.21.01199
dc.identifier.doi10.1200/JCO.21.01199
dc.identifier.doi10.1200/JCO.21.01199
dc.description.abstractPURPOSE: Survival in stage I seminoma is almost 100%. Computed tomography (CT) surveillance is an international standard of care, avoiding adjuvant therapy. In this young population, minimizing irradiation is vital. The Trial of Imaging and Surveillance in Seminoma Testis (TRISST) assessed whether magnetic resonance images (MRIs) or a reduced scan schedule could be used without an unacceptable increase in advanced relapses. METHODS: A phase III, noninferiority, factorial trial. Eligible participants had undergone orchiectomy for stage I seminoma with no adjuvant therapy planned. Random assignment was to seven CTs (6, 12, 18, 24, 36, 48, and 60 months); seven MRIs (same schedule); three CTs (6, 18, and 36 months); or three MRIs. The primary outcome was 6-year incidence of Royal Marsden Hospital stage ≥ IIC relapse (> 5 cm), aiming to exclude increases ≥ 5.7% (from 5.7% to 11.4%) with MRI (v CT) or three scans (v 7); target N = 660, all contributing to both comparisons. Secondary outcomes include relapse ≥ 3 cm, disease-free survival, and overall survival. Intention-to-treat and per-protocol analyses were performed. RESULTS: Six hundred sixty-nine patients enrolled (35 UK centers, 2008-2014); mean tumor size was 2.9 cm, and 358 (54%) were low risk (< 4 cm, no rete testis invasion). With a median follow-up of 72 months, 82 (12%) relapsed. Stage ≥ IIC relapse was rare (10 events). Although statistically noninferior, more events occurred with three scans (nine, 2.8%) versus seven scans (one, 0.3%): 2.5% absolute increase, 90% CI (1.0 to 4.1). Only 4/9 could have potentially been detected earlier with seven scans. Noninferiority of MRI versus CT was also shown; fewer events occurred with MRI (two [0.6%] v eight [2.6%]), 1.9% decrease (-3.5 to -0.3). Per-protocol analyses confirmed noninferiority. Five-year survival was 99%, with no tumor-related deaths. CONCLUSION: Surveillance is a safe management approach-advanced relapse is rare, salvage treatment successful, and outcomes excellent, regardless of imaging frequency or modality. MRI can be recommended to reduce irradiation; and no adverse impact on long-term outcomes was seen with a reduced schedule.
dc.formatPrint-Electronic
dc.format.extentJCO2101199 -
dc.languageeng
dc.language.isoengen_US
dc.publisherAmerican Society of Clinical Oncology (ASCO)en_US
dc.relation.ispartofJournal of Clinical Oncology
dc.subjectTRISST Trial Management Group and Investigators
dc.titleImaging Modality and Frequency in Surveillance of Stage I Seminoma Testicular Cancer: Results From a Randomized, Phase III, Noninferiority Trial (TRISST).en_US
dc.typeJournal Article
dc.date.updated2022-07-26T08:38:04Z
rioxxterms.versionNAen_US
rioxxterms.versionofrecord10.1200/JCO.21.01199en_US
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserveden_US
rioxxterms.licenseref.startdate2022-03-17
rioxxterms.typeJournal Article/Reviewen_US
pubs.author-urlhttps://www.ncbi.nlm.nih.gov/pubmed/35298280
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Clinical Academic Radiotherapy (Huddart)
pubs.publication-statusPublished online
icr.researchteamClinic Acad RT Huddarten_US
atmire.cua.enabled
dc.contributor.icrauthorRustin, Gordon
dc.contributor.icrauthorHuddart, Robert
icr.provenanceDeposited by Prof Robert Huddart on 2022-07-26. Deposit type is initial. No. of files: 1. Files: jco.21.01199.pdf


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