Gerritse, E. (2019) Stage I testicular germ cell tumor: histopathological aspects and a retrospective relapse analysis. thesis, Medicine.
Full text available on request.Abstract
Background & objective: Stage I testicular germ cell tumors (TGCT) are the most common type of neoplasia among males aged 20 to 35 years. Patients at higher risk of relapse are currently identified by histopathological risk factors; primary tumor size ≥ 4cm for all TGCT, rete testis invasion for seminoma and lymphovascular invasion for non-seminoma. Relapse rates for high-risk patients are 20% for seminoma and 50% for non-seminoma. Adjuvant chemotherapy is known to minimalize this risk, but due to curation rates for relapses of over 95% and possibly severe long term adverse effects this is not given to all patients. Our goal is to analyze other histopathological aspects and their relation to both relapse and established risk factors in order to formulate a more detailed relapse risk estimation. Methods: We performed a multicenter retrospective cohort study in a central region in the Netherlands. Data on included patients were acquired from the National Cancer and Pathology Registries (NKR and PALGA). Treating physicians provided data on relapse occurrence. Tumor characteristics were compared with established risk factors and relapse occurrence. Results: Primary tumor data were acquired for 511 patients: 303 seminoma and 208 nonseminoma. Relapse information was acquired for 83 patients with 7 confirmed seminoma relapses and 28 non-seminoma relapses. Conclusions: Necrosis was identified as a possible predictor of relapse for seminoma, whereas intratubular germ cell neoplasia, unclassified (ITGCNU) presence could predict a lower relapse rate within this group. For non-seminoma, possible factors with an increased risk of relapse were necrosis and predominance of embryonal carcinoma.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Faculty supervisor: and Leliveld-Kors, Dr. A.M. |
| Supervisor name: | Secondary supervisor: and Meijer, Dr. R.P. and Research supervisor: and Blok, Drs. J.M. and Department of Oncologic Urology, University Medical Center U |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:42 |
| Last Modified: | 25 Jun 2020 10:42 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/392 |
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