A trial looking at PET scans after surgery for testicular cancer (TE22)

Cancer type:

Testicular cancer

Status:

Results

Phase:

Other

This trial looked at PET scans to check for signs of cancer spread after surgery in men with non seminoma germ cell testicular cancer. This trial was supported by Cancer Research UK.

Doctors usually treat early stage testicular cancer with surgery. If the cancer has already grown into surrounding blood vessels or lymph vessels there is a higher chance of the cancer coming back. So this group of men usually has chemotherapy. But chemotherapy can have long term side effects. Doctors don’t want to give people treatments they don’t need. And the cancer will come back (recur) in less than half of this group of men if they do not have chemotherapy.

Doctors routinely use CT scans to check for signs of cancer spread after surgery. Earlier trials showed that a type of scan called a PET scan could pick up signs of cancer spread earlier than standard CT scans.

The aim of this trial was to find out if it is safe for men who have no signs of cancer spread on their PET scan, not to have chemotherapy. Instead, they would be closely monitored for any signs of their cancer coming back. This would then hopefully avoid unnecessary chemotherapy treatment.

Summary of results

The trial team found that while PET scans picked up signs of cancer spread earlier than standard CT scans, overall they were not very useful for this group of patients.

Just over 100 men took part in this trial. They all had surgery for early stage non seminoma germ cell testicular cancer. All the men had a PET scan at the beginning of the trial. The results of these scans showed that

88 men did not appear to have cancer that had spread – doctors call this ‘PET negative’ and this group of men had regular checkups with their doctors
22 men had cancer that had spread and they went on to have chemotherapy

Unfortunately, this trial stopped recruiting patients earlier than planned. The trial team found that the cancer came back in 33 out of the 88 men having regular checkups, who had not had chemotherapy. So it was not acceptable to continue with the trial.

The researchers found that in this group, PET scanning is not sensitive enough to show which men are very unlikely to have a recurrence of cancer which would make it safe for them to not have chemotherapy.

We have based this summary on information from the team who ran the trial. The information they sent us has been reviewed by independent specialists (peer reviewed Open a glossary item ) and published in a medical journal. The figures we quote above were provided by the trial team. We have not analysed the data ourselves.