Prognostic factor risk groups for clinical stage ı seminoma: An individual patient data analysis by the european association of urology testicular cancer guidelines panel and guidelines office

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dc.authorid0000-0003-0906-4417
dc.contributor.authorBoormans, Joost L.
dc.contributor.authorSylvester, Richard
dc.contributor.authorAnson Cartwright, Lynn
dc.contributor.authorGlicksman, Rachel M.
dc.contributor.authorHamilton, Robert J.
dc.contributor.authorHahn, Ezra
dc.contributor.authorDaugaard, Gedske
dc.contributor.authorLauritsen, Jakob
dc.contributor.authorWagner, Thomas
dc.contributor.authorAvuzzi, Barbara
dc.contributor.authorNicolai, Nicola
dc.contributor.authorDel Muro, Xavier García
dc.contributor.authorAparicio, Jorge
dc.contributor.authorStalder, Odile
dc.contributor.authorRothermundt, Christian
dc.contributor.authorFischer, Stefanie
dc.contributor.authordel Pilar Laguna Pes, Maria
dc.date.accessioned2024-06-06T11:44:50Z
dc.date.available2024-06-06T11:44:50Z
dc.date.issued2024
dc.departmentİstanbul Medipol Üniversitesi, Uluslararası Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Üroloji Ana Bilim Dalı
dc.description.abstractBACKGROUND: The relapse rate in patients with clinical stage I (CSI) seminomatous germ cell tumor of the testis (SGCTT) who were undergoing surveillance after radical orchidectomy is 4-30%, depending on tumor size and rete testis invasion (RTI). However, the level of evidence supporting the use of both risk factors in clinical decision-making is low. OBJECTIVE: We aimed to identify the most important prognostic factors for relapse in CSI SGCTT patients. DESIGN, SETTING, AND PARTICIPANTS: Individual patient data for 1016 CSI SGCTT patients diagnosed between 1994 and 2019 with normal postorchidectomy serum tumor marker levels and undergoing surveillance were collected from nine institutions. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Multivariable Cox proportional hazard regression models were fit to identify the most important prognostic factors. The primary endpoint was the time to first relapse by imaging and/or markers. Relapse probabilities were estimated by the Kaplan-Meier method. RESULTS AND LIMITATIONS: After a median follow-up of 7.7 yr, 149 (14.7%) patients had relapsed. Categorical tumor size (?2, >2-5, and >5 cm), presence of RTI, and lymphovascular invasion were used to form three risk groups: low (56.4%), intermediate (41.3%), and high (2.3%) risks with 5-yr cumulative relapse probabilities of 8%, 20%, and 44%, respectively. The model outperformed the currently used model with tumor size ?4 versus >4 cm and presence of RTI (Harrell's C index 0.65 vs 0.61). The low- and intermediate-risk groups were validated successfully in an independent cohort of 285 patients. CONCLUSIONS: The risk of relapse after radical orchidectomy in CSI SGCTT patients under surveillance is low. We propose a new risk stratification model that outperformed the current model and identified a small subgroup with a high risk of relapse. PATIENT SUMMARY: The risk of relapse after radical orchidectomy in patients with clinical stage I seminomatous germ cell tumor of the testis is low. We propose a new risk stratification model that outperformed the current model and identified a small subgroup with a high risk of relapse.
dc.identifier.citationBoormans, J. L., Sylvester, R., Anson Cartwright, L., Glicksman, R. M., Hamilton, R. J., Hahn, E. ... del Pilar Laguna Pes, M. (2024). Prognostic factor risk groups for clinical stage ı seminoma: An individual patient data analysis by the european association of urology testicular cancer guidelines panel and guidelines office. European Urology Oncology, 7(3), 537-543. http://dx.doi.org/10.1016/j.euo.2023.10.014
dc.identifier.doi10.1016/j.euo.2023.10.014
dc.identifier.endpage543
dc.identifier.issn2588-9311
dc.identifier.issue3
dc.identifier.pmid37951820
dc.identifier.scopus2-s2.0-85193649915
dc.identifier.scopusqualityQ1
dc.identifier.startpage537
dc.identifier.urihttp://dx.doi.org/10.1016/j.euo.2023.10.014
dc.identifier.urihttps://hdl.handle.net/20.500.12511/12584
dc.identifier.volume7
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthordel Pilar Laguna Pes, Maria
dc.language.isoen
dc.relation.ispartofEuropean Urology Oncologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectPrognosis
dc.subjectRelapse
dc.subjectRisk Factors
dc.subjectSeminoma Testis
dc.titlePrognostic factor risk groups for clinical stage ı seminoma: An individual patient data analysis by the european association of urology testicular cancer guidelines panel and guidelines office
dc.typeArticle

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