Clinical outcomes of late relapse in stage I seminoma.
Notice bibliographique
Résumé
4537 Background: This study aimed to identify characteristics associated with late relapse (LR) in stage I seminoma and determine clinical outcomes according to timing of relapse. Methods: Between 1981 and 2011, 949 stage I seminoma patients were managed at our institution. Of these, 254 were treated with adjuvant radiotherapy (aRT) and 695 were managed by active surveillance (AS). LR was defined as tumor recurrence more than 2 years after orchiectomy. Treatment at relapse was dependent on initial treatment and disease extent at relapse. Progression free survival (PFS) from end of treatment of first relapse and overall survival (OS) were calculated. Results: At median follow-up of 10.9 years, 129 patients relapsed at median of 12 months; 14 after aRT and 115 on AS. There was no significant difference between the proportion of patients with LR for aRT (3/14; 25%) vs. AS (29/115; 21%) with no specific clinicopathological features were associated with LR. Paraaortic node(s) was the most common relapse site in AS patients either in LR (n = 28, 97%; median size: 2.1 cm) or early relapse (n = 79, 92%; median size: 2 cm), whereas in aRT patients; all LR were in mediastinum, and early relapse was inguinal (n = 4), scrotal (n = 3) and distant (n = 4). Most LR occurred between 2-3 years (n = 14, 44%; 13 of them were AS patients), and 8 of 9 patients who had LR beyond 5 years were on AS. Treatment of first relapse for aRT group consisted of chemotherapy (n = 10), RT (n = 3) and surgery (n = 1); and for the AS group: RT (n = 87), chemotherapy (n = 26) and surgery (n = 2).Only 1 aRT patient developed second relapse. Nine AS patients had second relapse (7 after RT and 2 after chemotherapy) at a median (range) time of 13 (2–48) months. Second relapse was predominantly distant (9/10), however all were successfully salvaged with chemotherapy. The 5-year PFS from end of treatment of first relapse for the whole, aRT and AS groups were similar, 93%. Among AS group, there was no significant difference between early and late relapse in 5-year PFS (91% vs 100%, p= 0.1) or 10-year OS (96%, for both). Conclusions: In stage I seminoma, the extent and pattern of LR is similar to that for early relapse. For AS patients, selective use of RT/chemotherapy for relapse results in excellent outcomes regardless of timing of relapse.
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 | 0,000 | 0,000 |
| 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 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
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 ».