Back to Search
Start Over
Predicting retroperitoneal histology in postchemotherapy testicular germ cell cancer
- Source :
- European Urology, 51(2), 424-432. ELSEVIER SCIENCE BV, European Urology, 51(2), 424-432. Elsevier
- Publication Year :
- 2007
- Publisher :
- ELSEVIER SCIENCE BV, 2007.
-
Abstract
- Objectives: Surgical resection of postchemotherapy retroperitoneal lymph nodes is often performed in patients with advanced nonseminomatous testicular germ cell cancer. We previously developed a model to predict the probability that the lymph nodes contain only necrotic or fibrotic (benign) tissue versus mature teratoma and viable cancer (tumour) to identify patients who actually need resection. The present study used an updated model with new patient data and studied the validity of the updated model across various settings.Methods: We combined data of 544 patients from the original model with data of 550 new patients and performed a new logistic regression analysis, which included the same six predictors: histology of the primary tumour, prechemotherapy serum levels of alpha-fetoprotein, human chorionic gonadotropin, lactate dehydrogenase, residual mass size measured on computed tomography, and change in mass size. The validity of the updated model was studied in individual centres. Calibration of the predicted probabilities was assessed graphically and with the Hosmer-Lemeshow test. Discrimination was studied with the concordance (c)-statistic.Results: The updated model had slightly different, although more precise, regression coefficients. Statistically nonsignificant Hosmer-Lemeshow tests confirmed good calibration in most centres. The c-statistic for all centres except one exceeded 0.80. The updated model was valid over the complete range of predicted probabilities across a broad spectrum of centres.Conclusions: This finding gives confidence in the applicability of the model to select patients for resection, particularly patients with small residual masses and low predicted probabilities of benign tissue (i.e., substantial predicted risks of residual tumour). (c) 2006 European Association of Urology.
- Subjects :
- Male
medicine.medical_specialty
SURGERY
Urology
Concordance
Testicular Germ Cell Tumor
Logistic regression
histology
POSITRON-EMISSION-TOMOGRAPHY
SDG 3 - Good Health and Well-being
Predictive Value of Tests
TUMOR MASSES
Linear regression
REGRESSION
medicine
Retroperitoneal space
Humans
Retroperitoneal Space
lymphatic metastasis
VALIDITY
Models, Statistical
medicine.diagnostic_test
business.industry
TESTIS
Cancer
Neoplasms, Germ Cell and Embryonal
testicular neoplasms
CHEMOTHERAPY
BLEOMYCIN
medicine.disease
Surgery
prediction model
medicine.anatomical_structure
Positron emission tomography
Predictive value of tests
Radiology
business
model update
RESIDUAL MASS HISTOLOGY
RULE
Subjects
Details
- Language :
- English
- ISSN :
- 18737560 and 03022838
- Volume :
- 51
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- European Urology
- Accession number :
- edsair.doi.dedup.....c884a66405bdca966262850ae447ca97
- Full Text :
- https://doi.org/10.1016/j.eururo.2006.06.047