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- Title
Surveillance for patients with clinical stage I nonseminomatous testicular germ cell tumors.
- Authors
Li, Xiangdong; Guo, Shengjie; Wu, Zhiming; Dong, Pei; Li, Yonghong; Zhang, Zhiling; Yao, Kai; Han, Hui; Qin, Zike; Zhou, Fangjian; Liu, Zhuowei
- Abstract
Purpose: To assess the prognostic value of histological parameters in patients with clinical stage I nonseminomatous germ cell tumors (NSGCTs) undergoing active surveillance post-orchiectomy. Methods: Prognoses and recurrence patterns were investigated in 78 patients with CSI NSGCT who underwent orchiectomy. Immediately following orchiectomy, patients participated in active surveillance between 1999 and 2013 at Sun Yat-sen University Cancer Center, Guangzhou, China. Results: 23.1 % of the 78 investigated patients with CSI NSGCT relapsed, within a median time of 5.6 months It was determined using multivariate analysis that lymph vascular invasion (LVI) (OR 6.521; 95 % CI 1.872-22.721; p = 0.003) and the predominant presence of yolk sac tumor (greater than 50 %) (OR 3.537; 95 % CI 1.076-11.628; p = 0.038) independently correlated with relapse-free survival (RFS). Patients were categorized accordingly into three risk groups: low risk [<50 % presence of yolk sac tumor and LVI (−); n = 41], intermediate risk [50 % or greater presence of yolk sac tumor and LVI (+); n = 29], and high risk [50 % or greater presence of yolk sac tumor and LVI (+); n = 8]. Relapse rates of the low-risk, intermediate-risk, and high-risk groups were 7.3, 31.0, and 75.0 %, respectively. Conclusions: LVI and a predominant presence of yolk sac tumor are crucial risk factors for relapse of CSI NSGCT. For patients without either of these risk factors, active surveillance post-orchiectomy is a safe and effective approach for the initial management of CSI NSGCT.
- Subjects
GERM cell tumors; CANCER invasiveness; CASTRATION; CANCER relapse; MULTIVARIATE analysis; PROGNOSIS
- Publication
World Journal of Urology, 2015, Vol 33, Issue 9, p1351
- ISSN
0724-4983
- Publication type
Article
- DOI
10.1007/s00345-014-1454-7