NEUE PARAMETER ZUR VORHERSAGE DES PATHOLOGISCHEN STADIUMS BEI NICHTSEMINOMATOSEN HODENTUMOREN IM KLINISCHEN STADIUM I

Translated title of the contribution: New prognostic parameters for prediction of pathological stage in clinical stage I NSGCT of the testis

P. Albers, Thomas Ulbright, J. Albers, G. A. Miller, Richard Foster, J. P. Donohue

Research output: Contribution to journalArticle

Abstract

Traditional histopathological risk factors have failed to predict pathological stage accurately in clinical stage I nonseminomatous testicular germ cell tumours. Histopathology, flow cytometry, cytophotometry, and immunohistochemical staining techniques were used in an effort to define high- and low-risk groups for occult metastasis in a consecutive series of 105 patients who underwent retroperitoneal lymph node dissection. After multiple logistic regression analysis, the proliferative S + G2M cell cycle fraction of the aneuploid tumour stemline was the most highly predictive parameter of pathological stage (P = 0.0004). Using a cut-off of 41%, pathological stage II patients were predicted with a sensitivity of 71%. There were 61 patients with S + G2M values below 41%, and 43 of them had pathological stage I disease (negative predictive value 87%). A low volume of embryonal carcinoma was predominant in low-risk patients, and MIB-1 immunohistochemical staining identified a subgroup of 23% of patients with pathological stage I disease and at extremely low risk of metastatic disease. Assessment of tumour cell proliferation does not allow accurate classification of high-risk patients at a level that is adequate for clinical application. Patients who are at low risk of metastasis, however, can be identified by flow cytometry, immunohistochemical proliferation markers and volume of embryonal carcinoma with 90% certainty. These parameters deserve further study, since identification of a subgroup of patients at extremely low risk of metastasis could potentially reduce the overall morbidity in the management of clinical stage I nonseminomatous testis cancer.

Original languageGerman
Pages (from-to)316-323
Number of pages8
JournalUrologe - Ausgabe A
Volume34
Issue number4
StatePublished - 1995
Externally publishedYes

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Testis
Embryonal Carcinoma
Neoplasm Metastasis
Flow Cytometry
Staining and Labeling
Cytophotometry
Testicular Neoplasms
Aneuploidy
Lymph Node Excision
Neoplasms
Cell Cycle
Logistic Models
Regression Analysis
Cell Proliferation
Morbidity

Keywords

  • cytophotometry
  • flow cytometry
  • immunohistochemistry
  • nonseminomatous testicular germ cell tumors
  • prognostic factors

ASJC Scopus subject areas

  • Urology

Cite this

NEUE PARAMETER ZUR VORHERSAGE DES PATHOLOGISCHEN STADIUMS BEI NICHTSEMINOMATOSEN HODENTUMOREN IM KLINISCHEN STADIUM I. / Albers, P.; Ulbright, Thomas; Albers, J.; Miller, G. A.; Foster, Richard; Donohue, J. P.

In: Urologe - Ausgabe A, Vol. 34, No. 4, 1995, p. 316-323.

Research output: Contribution to journalArticle

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abstract = "Traditional histopathological risk factors have failed to predict pathological stage accurately in clinical stage I nonseminomatous testicular germ cell tumours. Histopathology, flow cytometry, cytophotometry, and immunohistochemical staining techniques were used in an effort to define high- and low-risk groups for occult metastasis in a consecutive series of 105 patients who underwent retroperitoneal lymph node dissection. After multiple logistic regression analysis, the proliferative S + G2M cell cycle fraction of the aneuploid tumour stemline was the most highly predictive parameter of pathological stage (P = 0.0004). Using a cut-off of 41{\%}, pathological stage II patients were predicted with a sensitivity of 71{\%}. There were 61 patients with S + G2M values below 41{\%}, and 43 of them had pathological stage I disease (negative predictive value 87{\%}). A low volume of embryonal carcinoma was predominant in low-risk patients, and MIB-1 immunohistochemical staining identified a subgroup of 23{\%} of patients with pathological stage I disease and at extremely low risk of metastatic disease. Assessment of tumour cell proliferation does not allow accurate classification of high-risk patients at a level that is adequate for clinical application. Patients who are at low risk of metastasis, however, can be identified by flow cytometry, immunohistochemical proliferation markers and volume of embryonal carcinoma with 90{\%} certainty. These parameters deserve further study, since identification of a subgroup of patients at extremely low risk of metastasis could potentially reduce the overall morbidity in the management of clinical stage I nonseminomatous testis cancer.",
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