Tumor Proliferative Activity is Predictive of Pathological Stage in Clinical Stage a Nonseminomatous Testicular Germ Cell Tumors
1996; Lippincott Williams & Wilkins; Volume: 155; Issue: 2 Linguagem: Inglês
10.1016/s0022-5347(01)66454-1
ISSN1527-3792
AutoresPeter Albers, Thomas M. Ulbright, Jutta Albers, Greg A. Miller, Attilio Orazi, William Crabtree, Jack Baniel, Terry Reister, Richard A. Sidner, Richard S. Foster, John P. Donohue,
Tópico(s)Renal cell carcinoma treatment
ResumoNo AccessJournal of UrologyClinical Urology: Original Article1 Feb 1996Tumor Proliferative Activity is Predictive of Pathological Stage in Clinical Stage a Nonseminomatous Testicular Germ Cell Tumors Peter Albers, Thomas M. Ulbright, Jutta Albers, Greg A. Miller, Attilio Orazi, William N. Crabtree, Jack Baniel, Terry Reister, Richard A. Sidner, Richard S. Foster, and John P. Donohue Peter AlbersPeter Albers , Thomas M. UlbrightThomas M. Ulbright , Jutta AlbersJutta Albers , Greg A. MillerGreg A. Miller , Attilio OraziAttilio Orazi , William N. CrabtreeWilliam N. Crabtree , Jack BanielJack Baniel , Terry ReisterTerry Reister , Richard A. SidnerRichard A. Sidner , Richard S. FosterRichard S. Foster , and John P. DonohueJohn P. Donohue View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)66454-1AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Traditional histopathological features have failed to predict accurately the pathological stage of clinical stage A nonseminomatous germ cell tumors of the testis. Based on pilot studies in nonconsecutive patients at our university, we evaluated nontraditional risk factors (cell cycle analysis by flow cytometry, deoxyribonucleic acid analysis by single cell cytophotometry [image analysis] and assessment of proliferative activity by immunohistochemistry) combined with histopathological features in consecutive patients with clinical stage A nonseminomatous testis cancer. Materials and Methods: Orchiectomy specimens from 105 consecutive patients with clinical stage A nonseminomatous germ cell tumors who underwent retroperitoneal lymph node dissection (76 with pathological stage A disease and 29 with proved metastasis) were recut, histopathologically reviewed, immunohistochemically stained with proliferation markers (for example Ki-67/MIB-1), and examined by flow cytometry and image analysis. Results: After multiple logistic regression analysis, the G2 M + S cell cycle fraction of the aneuploid tumor stemline was the most predictive parameter of pathological stage (p = 0.0004). Using a cutoff of 41 percent, patients with metastasis were predicted with a sensitivity of 71 percent. Of 61 patients with a G2 M + S value of less than 41 percent, 53 had pathological stage A cancer (negative predictive value 87 percent). A low volume of embryonal carcinoma was predominant in patients at low risk for metastasis and MIB-1 immunohistochemical staining identified 23 percent of patients with pathological stage A tumor who were at extremely low risk for metastatic disease. Conclusions: Assessment of tumor cell proliferation cannot classify accurately high risk patients at a clinically applicable level. However, identification of patients at low risk for metastasis by flow cytometry, immunohistochemical proliferation markers and volume of embryonal carcinoma may be possible at the 90 percent level. MIB-1 staining is able to classify patients at extremely low risk for metastasis. These parameters deserve further study, since identification of patients at extremely low risk for metastasis could potentially decrease overall morbidity in the management of clinical stage A nonseminomatous testis cancer. 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Link, Google Scholar Departments of Urology, Pathology and Biostatistics, Indiana University Medical Center, and Laboratory for Diagnostic and Analytic Cytometry, Indianapolis, Indiana.© 1996 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byHEIDENREICH A, ALBERS P, HARTMANN M, KLIESCH S, KÖHRMANN K, KREGE S, LOSSIN P and WEISSBACH L (2018) Complications of Primary Nerve Sparing Retroperitoneal Lymph Node Dissection for Clinical Stage I Nonseminomatous Germ Cell Tumors of the Testis: Experience of the German Testicular Cancer Study GroupJournal of Urology, VOL. 169, NO. 5, (1710-1714), Online publication date: 1-May-2003.HERMANS B, SWEENEY C, FOSTER R, EINHORN L and DONOHUE J (2018) RISK OF SYSTEMIC METASTASES IN CLINICAL STAGE I NONSEMINOMA GERM CELL TESTIS TUMOR MANAGED BY RETROPERITONEAL LYMPH NODE DISSECTIONJournal of Urology, VOL. 163, NO. 6, (1721-1724), Online publication date: 1-Jun-2000.Heidenreich A, Schenkmann N, Sesterhenn I, Mostofi F, McCarthy W, Heidenreich B and Moul J (2018) Immunohistochemical Expression of Ki-67 to Predict Lymph Node Involvement in Clinical Stage I Nonseminomatous Germ Cell TumorsJournal of Urology, VOL. 158, NO. 2, (620-625), Online publication date: 1-Aug-1997. Volume 155Issue 2February 1996Page: 579-586 Advertisement Copyright & Permissions© 1996 by American Urological Association, Inc.MetricsAuthor Information Peter Albers More articles by this author Thomas M. Ulbright More articles by this author Jutta Albers More articles by this author Greg A. Miller More articles by this author Attilio Orazi More articles by this author William N. Crabtree More articles by this author Jack Baniel More articles by this author Terry Reister More articles by this author Richard A. Sidner More articles by this author Richard S. Foster More articles by this author John P. Donohue More articles by this author Expand All Advertisement PDF downloadLoading ...
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