Risk factors for relapse in stage I non-seminomatous germ-cell tumors: Preliminary results of the German multicenter trial

Predictors of Occult Metastasis in Clinical Stage I Nonseminoma: A Systematic Review

“…17,26,33,43 Five studies performed RPLND, 17 studies observed patients until disease relapse, and one study randomly assigned patients to either RPLND or risk-adapted treatment. 39 One of the six studies that performed RPLND monitored relapse in PS I patients to find misclassified patients. 26 The reported median follow-up times in the studies with surveillance varied between 30 and 139 months.…”

“…64,65 The association of proliferative activity with occult metastasis in NSGCT has been determined with several techniques, such as cytophotometry, flow cytometry, and immunohistochemistry. 35,39,49 However, the analysis was based on only 212 patients, and the cutoff value of 70% was data driven in two of the three studies. Examples of immunohistochemical assessments are staining primary tumor cells for proliferating cell nuclear antigen or MIB-1.…”

“…26,39 When more than one definition of occult metastasis was reported, we used the most informative definition. If patients underwent RPLND, positive lymph nodes might reveal occult metastasis (pathologic stage II [PS II]).…”

Management of Testicular Cancer: 16 years' Experience from Southwest Finland

“…Short-course adjuvant chemotherapy (two cycles of BEP) has been recommended to prevent relapse in stage I non-seminoma patients, and it is free from signi cant long-term toxicity (17). Histopathological risk factors such as tumour invasion of the testicular veins and lymphatics (19) can predict only some of the relapses in stage I non-seminomas (15), and the justi cation for performing risk analyses in these patients in small centres has been regarded as questionable (20). There is evidence that many patients would select adjuvant chemotherapy rather than surveillance alone, even at relatively low levels of risk of recurrence (17).…”

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

“…The high-and low-risk groups can be defined by expert imaging evaluation and by histopathologic and biologic markers of the primary tumor, or by both methods. Preliminary data of this prospective evaluation have been published, 8 and this article presents the final evaluation of these data. Both models have been confirmed in retrospective series.…”