Friedemann Zengerling1,2, Dirk Beyersdorff3, Jonas Busch4, Julia Heinzelbecker5, David Pfister6, Christian Ruf7, Christian Winter8, Peter Albers9, Sabine Kliesch10, Stefanie Schmidt11. 1. Department of Urology and Pediatric Urology, University Hospital of Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Germany. friedemann.zengerling@uniklinik-ulm.de. 2. UroEvidence at Deutsche Gesellschaft Für Urologie, Berlin, Germany. friedemann.zengerling@uniklinik-ulm.de. 3. Clinic and Polyclinic for Diagnostic and Interventional Radiology and Nuclear Medicine, University Hospital Hamburg-Eppendorf, Hamburg, Germany. 4. Department of Urology, Charité Universitaetsmedizin Berlin, Berlin, Germany. 5. Department of Urology and Paediatric Urology, Saarland University Medical Centre and Saarland University, Homburg, Germany. 6. Department of Urology, University Hospital Cologne, Cologne, Germany. 7. Department of Urology, Bundeswehrkrankenhaus, Ulm, Germany. 8. Urologie Neandertal, Erkrath, Germany. 9. Department of Urology, University Hospital Düsseldorf, Düsseldorf, Germany. 10. Centre of Reproductive Medicine and Andrology, Department of Clinical and Surgical Andrology, University Hospital Münster, Münster, Germany. 11. UroEvidence at Deutsche Gesellschaft Für Urologie, Berlin, Germany.
Abstract
OBJECTIVE: To systematically evaluate evidence on prognostic factors for tumor recurrence in clinical stage I nonseminoma patients other than lymphovascular invasion (LVI). METHODS: We performed a systematic literature search in the biomedical databases Medline (via Ovid) and Cochrane Central Register of Controlled Trials (search period January 2010 to February 2021) for full text publications in English and German language, reporting on retro- or prospectively assessed prognostic factors for tumor recurrence in patients with stage I nonseminomatous germ cell tumors. RESULTS: Our literature search yielded eleven studies reporting on 20 potential prognostic factors. Results are based on cohort studies of mostly moderate to low quality. Five out of eight studies found a significant association of embryonal carcinoma (EC) in the primary tumor with relapse. Among the different risk definitions of embryonal carcinoma (presence, predominance, pure), presence of EC alone seems to be sufficient for prognostification. Interesting results were found for rete testis invasion, predominant yolk sac tumor, T-stage and history of cryptorchidism, but the sparse data situation does not justify their clinical use. CONCLUSIONS: No additional factors that meet the prognostic value of LVI, especially when determined by immunohistochemistry, could be identified through our systematic search. The presence of EC might serve as a second, subordinate prognostic factor for clinical use as the data situation is less abundant than the one of LVI. Further efforts are necessary to optimize the use of these two prognostic factors and to evaluate and validate further potential factors with promising preliminary data.
OBJECTIVE: To systematically evaluate evidence on prognostic factors for tumor recurrence in clinical stage I nonseminoma patients other than lymphovascular invasion (LVI). METHODS: We performed a systematic literature search in the biomedical databases Medline (via Ovid) and Cochrane Central Register of Controlled Trials (search period January 2010 to February 2021) for full text publications in English and German language, reporting on retro- or prospectively assessed prognostic factors for tumor recurrence in patients with stage I nonseminomatous germ cell tumors. RESULTS: Our literature search yielded eleven studies reporting on 20 potential prognostic factors. Results are based on cohort studies of mostly moderate to low quality. Five out of eight studies found a significant association of embryonal carcinoma (EC) in the primary tumor with relapse. Among the different risk definitions of embryonal carcinoma (presence, predominance, pure), presence of EC alone seems to be sufficient for prognostification. Interesting results were found for rete testis invasion, predominant yolk sac tumor, T-stage and history of cryptorchidism, but the sparse data situation does not justify their clinical use. CONCLUSIONS: No additional factors that meet the prognostic value of LVI, especially when determined by immunohistochemistry, could be identified through our systematic search. The presence of EC might serve as a second, subordinate prognostic factor for clinical use as the data situation is less abundant than the one of LVI. Further efforts are necessary to optimize the use of these two prognostic factors and to evaluate and validate further potential factors with promising preliminary data.
Authors: Sabine Kliesch; Stefanie Schmidt; Doris Wilborn; Clemens Aigner; Walter Albrecht; Jens Bedke; Matthias Beintker; Dirk Beyersdorff; Carsten Bokemeyer; Jonas Busch; Johannes Classen; Maike de Wit; Klaus-Peter Dieckmann; Thorsten Diemer; Anette Dieing; Matthias Gockel; Bernt Göckel-Beining; Oliver W Hakenberg; Axel Heidenreich; Julia Heinzelbecker; Kathleen Herkommer; Thomas Hermanns; Sascha Kaufmann; Marko Kornmann; Jörg Kotzerke; Susanne Krege; Glen Kristiansen; Anja Lorch; Arndt-Christian Müller; Karin Oechsle; Timur Ohloff; Christoph Oing; Ulrich Otto; David Pfister; Renate Pichler; Heinrich Recken; Oliver Rick; Yvonne Rudolph; Christian Ruf; Joachim Schirren; Hans Schmelz; Heinz Schmidberger; Mark Schrader; Stefan Schweyer; Stefanie Seeling; Rainer Souchon; Christian Winter; Christian Wittekind; Friedemann Zengerling; D H Zermann; Roger Zillmann; Peter Albers Journal: Urol Int Date: 2021-01-22 Impact factor: 2.089
Authors: Gedske Daugaard; Maria Gry Gundgaard; Mette Saksø Mortensen; Mads Agerbæk; Niels Vilstrup Holm; Mikael Rørth; Hans von der Maase; Ib Jarle Christensen; Jakob Lauritsen Journal: J Clin Oncol Date: 2014-09-29 Impact factor: 44.544
Authors: Sabine Kliesch; Stefanie Schmidt; Doris Wilborn; Clemens Aigner; Walter Albrecht; Jens Bedke; Matthias Beintker; Dirk Beyersdorff; Carsten Bokemeyer; Jonas Busch; Johannes Classen; Maike de Wit; Klaus-Peter Dieckmann; Thorsten Diemer; Anette Dieing; Matthias Gockel; Bernt Göckel-Beining; Oliver W Hakenberg; Axel Heidenreich; Julia Heinzelbecker; Kathleen Herkommer; Thomas Hermanns; Sascha Kaufmann; Marko Kornmann; Jörg Kotzerke; Susanne Krege; Glen Kristiansen; Anja Lorch; Arndt-Christian Müller; Karin Oechsle; Timur Ohloff; Christoph Oing; Ulrich Otto; David Pfister; Renate Pichler; Heinrich Recken; Oliver Rick; Yvonne Rudolph; Christian Ruf; Joachim Schirren; Hans Schmelz; Heinz Schmidberger; Mark Schrader; Stefan Schweyer; Stefanie Seeling; Rainer Souchon; Christian Winter; Christian Wittekind; Friedemann Zengerling; Dirk-Henrik Zermann; Roger Zillmann; Peter Albers Journal: Urol Int Date: 2021-01-07 Impact factor: 2.089
Authors: T Tandstad; O Ståhl; U Håkansson; O Dahl; H S Haugnes; O H Klepp; C W Langberg; A Laurell; J Oldenburg; A Solberg; K Söderström; E Cavallin-Ståhl; U Stierner; R Wahlquist; N Wall; G Cohn-Cedermark Journal: Ann Oncol Date: 2014-08-11 Impact factor: 32.976
Authors: Christian Kollmannsberger; Torgrim Tandstad; Philippe L Bedard; Gabriella Cohn-Cedermark; Peter W Chung; Michael A Jewett; Tom Powles; Padraig R Warde; Siamak Daneshmand; Andrew Protheroe; Scott Tyldesley; Peter C Black; Kim Chi; Alan I So; Malcom J Moore; Craig R Nichols Journal: J Clin Oncol Date: 2014-08-18 Impact factor: 44.544
Authors: J Oldenburg; J Aparicio; J Beyer; G Cohn-Cedermark; M Cullen; T Gilligan; U De Giorgi; M De Santis; R de Wit; S D Fosså; J R Germà-Lluch; S Gillessen; H S Haugnes; F Honecker; A Horwich; A Lorch; D Ondruš; G Rosti; A J Stephenson; T Tandstad Journal: Ann Oncol Date: 2014-11-06 Impact factor: 32.976
Authors: Sophie D Fosså; Milada Cvancarova; Linlin Chen; Annie L Allan; Jan Oldenburg; Derick R Peterson; Lois B Travis Journal: J Clin Oncol Date: 2011-02-07 Impact factor: 44.544
Authors: Peter Albers; Roswitha Siener; Sabine Kliesch; Lothar Weissbach; Susanne Krege; Christoph Sparwasser; Harald Schulze; Axel Heidenreich; Werner de Riese; Volker Loy; Erhard Bierhoff; Christian Wittekind; Rolf Fimmers; Michael Hartmann Journal: J Clin Oncol Date: 2003-04-15 Impact factor: 44.544
Authors: Joost M Blok; Ilse Pluim; Gedske Daugaard; Thomas Wagner; Katarzyna Jóźwiak; Erica A Wilthagen; Leendert H J Looijenga; Richard P Meijer; J L H Ruud Bosch; Simon Horenblas Journal: BJU Int Date: 2020-01-08 Impact factor: 5.588