This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Moul, J. W. Articles by Sesterhenn, I. A. Search for Related Content PubMed PubMed Citation Articles by Moul, J. W. Articles by Sesterhenn, I. A.

Percentage of Embryonal Carcinoma and of Vascular Invasion Predicts Pathological Stage in Clinical Stage I Nonseminomatous Testicular Cancer¹

Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland 20814-4799 [J. W. M., W. F. M.]; Urology Services, Department of Surgery and Department of Clinical Investigation, Walter Reed Army Medical Center, Washington, DC 20307-5001 [E. B. F., J. W. M.]; and Department of Genitourinary Pathology, Armed Forces Institute of Pathology, Washington, DC 20306-6000 [I. A. S.]

² Supported in part by Grant R090BJ from the Uniformed Services University of the Health Sciences and by Grant 2873 from the Department of Clinical Investigation, Walter Reed Army Medical Center. To whom requests for reprints should be addressed, at (Department of Surgery, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814-4799.

We analyzed 92 clinical stage I nonseminomatous testicular germ cell tumors for primary tumor histological factors that would distinguish true pathological stage I disease (N = 54) from those patients who harbored occult disease and actually were later found to have pathological stage II disease (N = 38). Primary tumor pathological material was analyzed for vascular invasion, lymphatic invasion, tunical invasion, and quantitative determination of percentage of the primary tumor composed of embryonal carcinoma, yolk sac carcinoma, teratoma, and seminoma. Univariate logistic regression analyses revealed that vascular invasion (P = 0.0001), percentage of embryonal carcinoma (P = 0.0001), lymphatic invasion (P = 0.0001), and tunical invasion (P = 0.0013) were higher in pathological stage II and that percentage of teratoma (P = 0.0001) and of yolk sac carcinoma (P = 0.0174) were higher in stage I. Percentage of seminoma was not significant. Individually, these parameters were able to correctly predict occult disease 66.3 to 80.4% of the time. In multivariate logistic regression analysis, only vascular invasion and percentage of embryonal carcinoma remained significant, and a model using these two variables was able to correctly predict stage 85.9% of the time. Vascular invasion and determination of percentage of embryonal carcinoma should be assessed for all clinical stage I nonseminomatous germ cell tumor patients and the model presented herein can be used clinically to predict the likelihood of occult disease and dictate therapy.

¹ The opinions and assertions contained herein are the private views of the authors and are not to be construed as reflective of the official views of the United States Army or Department of Defense.

The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked advertisement in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

Received 10/28/93. Accepted 11/26/93.

This article has been cited by other articles:

				P. Maroto, X. G. del Muro, J. Aparicio, L. Paz-Ares, J. A. Arranz, J. Guma, J. Terrassa, J. Barnadas, J. Dorta, and J. R. Germa-Lluch Multicentre risk-adapted management for stage I non-seminomatous germ cell tumours Ann. Onc., December 1, 2005; 16(12): 1915 - 1920. [Abstract] [Full Text] [PDF]

				Y. Vergouwe, E. W. Steyerberg, M. J.C. Eijkemans, P. Albers, and J. D. F. Habbema Predictors of Occult Metastasis in Clinical Stage I Nonseminoma: A Systematic Review J. Clin. Oncol., November 15, 2003; 21(22): 4092 - 4099. [Abstract] [Full Text] [PDF]