Sema down.

If you take a look at the NCCN guidelines for seminoma, you’ll see that post-treatment imaging for patients with metastatic disease includes PET/CT for those with visible residual disease. This study questions the true utility of PET/CT in that scenario. Patients with ≥3 cm residual PET-avid disease underwent imaging surveillance, biopsy, or resection with the latter two preferred by the NCCN. Interestingly, residual disease was found in zero biopsies and only 19% of resections. Patients who had resections did achieve a lower rate of relapse at 8% versus 22% without resection, but all but one eventual relapse was successfully salvaged. TBL: The positive predictive value of PET/CT in patients with residual metastatic seminoma is only 23% and most can be safely observed. | Cathomas, J Clin Oncol 2018