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- Title
Risk factors for relapse in patients with clinical stage I testicular nonseminomatous germ cell tumors.
- Authors
Dong, Pei; Liu, Zhuo-Wei; Li, Xiang-Dong; Li, Yong-Hong; Yao, Kai; Wu, Song; Qin, Zi-Ke; Han, Hui; Zhou, Fang-Jian
- Abstract
Prediction of oncological outcomes facilitates individualized risk-adapted management for clinical stage I testicular nonseminomatous germ cell tumors (CS I NSGCTs). We investigated risk factors for relapse following orchidectomy, with particular focus on patients with active surveillance. Patients with CS I NSGCTs treated by retroperitoneal lymph node dissection (RPLND), chemotherapy, or surveillance between January 1997 and December 2009 were identified. Demographic and post-operative records were collected. Disease-specific survival and progression-free survival (PFS) rates were estimated using Kaplan-Meier analysis. Cox regression analysis was used to confirm variables that influenced disease relapse. A median follow-up period of 82 months was achieved in 89 patients, of whom 9 (8 in surveillance and 1 in chemotherapy group) had relapses. Cumulative 5-year PFS rates were 74.1, 92.3, and 100 % for the surveillance, chemotherapy, and RPLND groups, respectively ( p = 0.01). The relapse rate was significantly higher in patients presented with lymphatic/vascular invasion (LVI) than in those without LVI (26.6 vs. 6.8 %, p = 0.02). In the surveillance group, a higher relapse rate was associated with history of cryptorchidism (50 vs. 13.3 %, p = 0.02) and an age older than 13 years (33.3 vs. 5.9 %, p = 0.04). On multivariate analysis, patient age (OR 1.16; p = 0.05), history of cryptorchidism (OR 0.09; p = 0.01), and LVI (OR 12.10; p = 0.01) were significantly associated with relapse during surveillance. The disease-free period is short in the patients with surveillance. LVI, patient age, and history of cryptorchidism may be used as predictors for relapse during surveillance.
- Subjects
TESTICULAR cancer; CANCER chemotherapy; CANCER treatment; CANCER relapse; CRYPTORCHISM; GERM cell tumors
- Publication
Medical Oncology, 2013, Vol 30, Issue 1, p1
- ISSN
1357-0560
- Publication type
Article
- DOI
10.1007/s12032-013-0494-y