831 PATHOLOGICAL ANALYSIS OF RESECTED GONADAL VEIN AND TESTICLE POST-CEMOTHERAPY AT TIME OF RETROPERITONEAL LYMPH NODE DISSECTION FOR TREATMENT OF METASTATIC GERM CELL TESTICULAR CANCER
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Résumé
You have accessJournal of UrologyPenis/Testis/Urethra: Benign & Malignant Disease1 Apr 2011831 PATHOLOGICAL ANALYSIS OF RESECTED GONADAL VEIN AND TESTICLE POST-CEMOTHERAPY AT TIME OF RETROPERITONEAL LYMPH NODE DISSECTION FOR TREATMENT OF METASTATIC GERM CELL TESTICULAR CANCER Charles Metcalfe, Lydia Liao, Martin Gleave, Larry Goldenberg, and Allan So Charles MetcalfeCharles Metcalfe Vancouver, Canada , Lydia LiaoLydia Liao Vancouver, Canada , Martin GleaveMartin Gleave Vancouver, Canada , Larry GoldenbergLarry Goldenberg Vancouver, Canada , and Allan SoAllan So Vancouver, Canada View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.651AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The role of performing a retroperitoneal lymph node dissection (RPLND) for node positive disease post-chemotherapy for metastatic germ cell cancer is well established. The complete dissection of the gonadal vein to the level of the deep inguinal ring is viewed as a key surgical maneuver in rendering the patient disease free. Moreover, in patients in whom chemotherapy was initiated prior to orchiectomy, radical orchiectomy of the initiating testicle is performed at the time of RPLND to complete curative management. We evaluate the pathological findings of full gonadal vein dissection and the orchiectomy specimens in patients treated with RPLND post-cisplatin based chemotherapy for metastatic non-seminomatous germ cell cancer. METHODS Pathologic databases from a single tertiary institution that performs the majority of post chemo-RPLNDs (PC-RPLNDs) in British Columbia were reviewed from 1990–2010. Two different searches were performed retrospectively. The first being all PC-RPLND cases with pathologic analysis of the gonadal vein, and the second being all PC-RPLND cases combined with orchiectomy of the cancerous testicle. The data was analyzed and the presence of disease from gonadal vein dissection and from the orchiectomy specimens was examined. RESULTS Between 1990–2010, 117 PC-RPLND's were performed with pathological analysis of the lymph node tissue and the ipsilateral gonadal vein. 106 (90%) of gonadal veins and the adjacent tissue was negative for any disease. 7 (6%) had evidence of teratoma, 2 (2%) had embryonal tissue, 1 (1%) and 1 (1%) were positive for choriocarcinoma and mixed germ cell tissue respectively. Of the 11 positive samples, 5 had invasive disease within the gonadal vein and 6 had node positive disease along the gonadal vein. The second search revealed twenty-three cases in which the orchiectomy was performed post-chemotherapy at time of RPLND. 16 (70%) testicles had no evidence of disease and the remaining 7 (30%) revealed teratoma. The RPLND resulted in 14 (61%) of node dissections negative for disease, 7 (30%) and 2 (9%) detected teratoma and mixed germ cell disease respectively. CONCLUSIONS With the goal of a post-chemotherapy RPLND being complete cure, the added morbidity of the gonadal vein dissection and orchiectomy in patients with remaining testicle is justified. These steps are essential to maximize treatment. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e334-e335 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Charles Metcalfe Vancouver, Canada More articles by this author Lydia Liao Vancouver, Canada More articles by this author Martin Gleave Vancouver, Canada More articles by this author Larry Goldenberg Vancouver, Canada More articles by this author Allan So Vancouver, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,002 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,005 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».