Abstract

INTRODUCTION In patients with advanced testicular cancer of the seminoma type who have post-chemotherapy residual lesions of more than 3 cm, PET-CT could select a subgroup susceptible to being managed with follow-up, avoiding unnecessary surgical resection of non-viable tumor. METHODS We conducted a search in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple sources of information, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the identified reviews, analyzed data from the primary studies, performed a meta-analysis, and prepared a summary table of results using the GRADE method. RESULTS AND CONCLUSIONS We identified three systematic reviews that together included 11 primary studies, none of which is a randomized trial. We conclude that the use of PET-CT in the evaluation of post-chemotherapy residual masses in patients with seminoma-type testicular cancer could avoid a significant percentage of unnecessary surgeries (low-certainty evidence). In addition, the use of PET-CT could present favorable risk/benefit and cost/benefit balances in the management of patients with seminoma-type testicular cancer. However, systematic reviews and primary studies that directly assess the diagnostic impact of the test are required.