Flow‐cytometric and quantitative histologic parameters as prognostic indicators for occult retroperitoneal disease in clinical‐stage‐I non‐seminomatous testicular germ‐cell tumors

Riese, Werner de; Riese, Cornelia de; Ulbright, Thomas M.; Walker, Edwin; Messemer, Jon; Jones, Jeffrey A.; Reister, Terry; Albers, Peter; Allhoff, E. P.; Foster, Richard S.; Donohue, John P.

doi:10.1002/ijc.2910570503

Cited by 31 publications

(17 citation statements)

References 18 publications

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“…Vascular invasion was the predominant finding. This was confirmed in several retrospective analyses and prospective trials that used vascular invasion to determine the high-risk group that had subsequently been treated by adjuvant chemotherapy [7,29,31,[33][34][35][36][37][38][39]. The relapse rate of patients without vascular invasion who had been managed by observation ranged between 14% and 22%.…”

Section: Discussionmentioning

confidence: 67%

Risk-adapted management for patients with clinical stage I non-seminomatous germ cell tumour of the testis

Güney

Sönmez

et al. 2008

Med Oncol

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Testis cancer is the most common cancer in young men and its incidence continues to rise. Even if prognosis is considered as good, a group with bad prognosis still remains. We aimed to evaluate whether two courses of chemotherapy after orchiectomy in patients with clinical stage I, non-seminomatous germ cell testicular tumour at high risk of relapse, will spare patients additional chemotherapy or surgery. High-risk patients had one or more of the following: preorchiectomy alpha-fetoprotein level of 80 ng/dl, 80% embryonal cell carcinoma or greater, vessel invasion in the primary tumour and tumour stage pT2 or greater. Low-risk patients had none of these factors or had 50% teratoma or more without vessel invasion. High-risk patients were offered two 21-day courses of outpatient chemotherapy consisting cisplatin, etoposide and bleomycin (BEP). Low-risk patients were observed. Of the 108 patients, we classified 71 as high risk and 37 as low risk of relapse. All of the high-risk patients received two courses of BEP chemotherapy. Low-risk patients were kept on close-up. The median follow-up was 26 months (range 10-60). Of the 71 patients in high-risk group, 3 relapsed with viable cancer and required additional chemotherapy and 1 patient with normal biomarkers and a late-appearing mass underwent retroperitoneal lympadenectomy for mature teratoma. All 4 relapsed patients were in high-risk group and presently they are free of disease. None of the 37 patients at low risk of recurrences developed relapse. We recommend two courses of adjuvant chemotherapy after postorchiectomy for high-risk patients with stage I non-seminomatous germ cell tumour of the testis. Adjuvant chemotherapy for these patients results in a low relapse and morbidity, wich compares favourably with the results of surveillance or RPLND. This well-tolerated approach may spare patients additional surgery or protracted chemotherapy, reduce the cost and eliminate the compliance problems associated with intensive follow up of high-risk patients.

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Section: Discussionmentioning

confidence: 67%

Risk-adapted management for patients with clinical stage I non-seminomatous germ cell tumour of the testis

Güney

Sönmez

et al. 2008

Med Oncol

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“…11,12 Flow cytometry was performed with a Becton Dickinson (San Jose, CA) flow cytometer. The preparation of the single-cell solution from the paraffinembedded section was performed as previously published.…”

Section: Flow Cytometric Assessment Of Proliferation Ratesmentioning

confidence: 99%

Risk Factors for Relapse in Clinical Stage I Nonseminomatous Testicular Germ Cell Tumors: Results of the German Testicular Cancer Study Group Trial

Albers

Siener²,

Kliesch³

et al. 2003

JCO

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282

138

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Even with an optimal combination of prognostic factors and reference pathology, more than one third of patients predicted to have pathologic stage II or relapse during follow-up will not harbor metastatic disease and, therefore, would be overtreated with adjuvant therapy. However, patients at low risk may be predicted at an 86.5% level, and thus, surveillance in highly compliant patients would be a valuable option. For high-risk patients, further reduction of adjuvant treatment is necessary.

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“…13 The preliminary results of this study led to a larger series comparing tumor biologic parameters at Bonn University Medical Center. The clinical staging included tumor markers (alpha-fetoprotein, b huwith traditional histopathologic risk factors in patients with Stage I NSGCT.…”

Section: Patientsmentioning

confidence: 98%

MIB‐1 immunohistochemistry in clinical Stage I nonseminomatous testicular germ cell tumors predicts patients at low risk for metastasis

Albers

Bierhoff

Neu

et al. 1997

Cancer

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Flow‐cytometric and quantitative histologic parameters as prognostic indicators for occult retroperitoneal disease in clinical‐stage‐I non‐seminomatous testicular germ‐cell tumors

Cited by 31 publications

References 18 publications

Risk-adapted management for patients with clinical stage I non-seminomatous germ cell tumour of the testis

Risk-adapted management for patients with clinical stage I non-seminomatous germ cell tumour of the testis

Risk Factors for Relapse in Clinical Stage I Nonseminomatous Testicular Germ Cell Tumors: Results of the German Testicular Cancer Study Group Trial

MIB‐1 immunohistochemistry in clinical Stage I nonseminomatous testicular germ cell tumors predicts patients at low risk for metastasis

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