PURPOSE: To investigate whether the use of pre-orchiectomy instead of pre-chemotherapy tumor marker (TM) levels has an impact on the International Germ Cell Consensus Classification (IGCCCG) risk group assignment in patients with metastatic germ cell tumors (GCT). METHODS: Demographic and clinical information of all patients treated for primary metastatic testicular non-seminomatous GCT in our tertiary care academic center were extracted from medical charts. IGCCCG risk group assignment was correctly performed with pre-chemotherapy marker levels and additionally with pre-orchiectomy marker levels. Agreement between pre-chemotherapy and pre-orchiectomy risk group assignments was assessed using Cohen's kappa. RESULTS: Our cohort consisted of 83 patients. The use of pre-orchiectomy TMs resulted in an IGCCCG risk group upstaging in 12 patients (16%, 8 patients from good to intermediate risk and 4 patients from intermediate to poor risk) and a downstaging in 1 patient (1.2%, from intermediate- to good-risk). The agreement between pre-orchiectomy and pre-chemotherapy IGCCCG risk groups resulted in a Cohen's kappa of 0.888 (p < 0.001). CONCLUSIONS: Using pre-orchiectomy TMs can result in incorrect IGCCCG risk group assignment, which in turn can impact on the clinical management and follow-up of patients with metastatic GCT. Thus, adherence to the IGCCCG standard using pre-chemotherapy TMs levels is recommended.
PURPOSE: To investigate whether the use of pre-orchiectomy instead of pre-chemotherapy tumor marker (TM) levels has an impact on the International Germ Cell Consensus Classification (IGCCCG) risk group assignment in patients with metastatic germ cell tumors (GCT). METHODS: Demographic and clinical information of all patients treated for primary metastatic testicular non-seminomatous GCT in our tertiary care academic center were extracted from medical charts. IGCCCG risk group assignment was correctly performed with pre-chemotherapy marker levels and additionally with pre-orchiectomy marker levels. Agreement between pre-chemotherapy and pre-orchiectomy risk group assignments was assessed using Cohen's kappa. RESULTS: Our cohort consisted of 83 patients. The use of pre-orchiectomy TMs resulted in an IGCCCG risk group upstaging in 12 patients (16%, 8 patients from good to intermediate risk and 4 patients from intermediate to poor risk) and a downstaging in 1 patient (1.2%, from intermediate- to good-risk). The agreement between pre-orchiectomy and pre-chemotherapy IGCCCG risk groups resulted in a Cohen's kappa of 0.888 (p < 0.001). CONCLUSIONS: Using pre-orchiectomy TMs can result in incorrect IGCCCG risk group assignment, which in turn can impact on the clinical management and follow-up of patients with metastatic GCT. Thus, adherence to the IGCCCG standard using pre-chemotherapy TMs levels is recommended.
Authors: João Lobo; Ana Laura Costa; Mariana Cantante; Rita Guimarães; Paula Lopes; Luís Antunes; Isaac Braga; Jorge Oliveira; Mattia Pelizzola; Rui Henrique; Carmen Jerónimo Journal: J Transl Med Date: 2019-03-12 Impact factor: 5.531
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Authors: Pia Paffenholz; Tim Nestler; Yasmine Maatoug; Melanie von Brandenstein; Barbara Köditz; David Pfister; Axel Heidenreich Journal: Urologe A Date: 2021-01-11 Impact factor: 0.639
Authors: Christoph Seidel; Gedske Daugaard; Tim Nestler; Alexey Tryakin; Mikhail Fedyanin; Christian Daniel Fankhauser; Thomas Hermanns; Jorge Aparicio; Julia Heinzelbecker; Pia Paffenholz; Axel Heidenreich; Ugo De Giorgi; Richard Cathomas; Anja Lorch; Anna Fingerhut; Fabian Gayer; Felix Bremmer; Patrizia Giannatempo; Andrea Necchi; Daniele Raggi; Gaetano Aurilio; Chiara Casadei; Marcus Hentrich; Ben Tran; Klaus-Peter Dieckmann; Margarido Brito; Christian Ruf; Alessandro Mazzocca; Bruno Vincenzi; Olof Stahl; Carsten Bokemeyer; Christoph Oing Journal: World J Urol Date: 2021-03-08 Impact factor: 4.226