PD09-10 TEMPORAL TRENDS IN MANAGEMENT AND OUTCOMES OF TESTICULAR CANCER: A POPULATION-BASED STUDY
Notice bibliographique
Résumé
You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Practice Patterns, Quality of Life and Shared Decision Making II1 Apr 2017PD09-10 TEMPORAL TRENDS IN MANAGEMENT AND OUTCOMES OF TESTICULAR CANCER: A POPULATION-BASED STUDY Michael Leveridge, D Robert Siemens, Kelly Brennan, Jason Izard, Safiya Karim, and Christopher Booth Michael LeveridgeMichael Leveridge More articles by this author , D Robert SiemensD Robert Siemens More articles by this author , Kelly BrennanKelly Brennan More articles by this author , Jason IzardJason Izard More articles by this author , Safiya KarimSafiya Karim More articles by this author , and Christopher BoothChristopher Booth More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.560AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Treatment guidelines for early-stage testicular cancer have increasingly recommended de-escalation of therapy. We sought to describe changes in routine clinical practice and whether this has compromised survival in the general population. METHODS The Ontario Cancer Registry was linked to electronic records of treatment to identify all patients diagnosed with testicular cancer and treated with orchiectomy in Ontario during 2000-2010. Treatment after orchiectomy was classified as radiotherapy (RT), retroperitoneal lymph node dissection (RPLND), chemotherapy, or none. Stage of disease at diagnosis was not available. Cancer-specific (CSS) and overall survival (OS) were measured from date of orchiectomy. The chi-squared test was used to evaluate temporal trends in practice patterns; the log-rank trend test was used to evaluate whether outcomes changed over time. RESULTS Orchiectomy pathology reports were available for 86% (2821/3281) of all cases in Ontario; the study population included 1580 and 1105 cases of seminoma and non-seminoma (NSGCT); other histologies were excluded. Median age was 34 years. Among patients with seminoma there was a significant increase in the proportion of patients with no active treatment after orchiectomy (from 33% to 66%, p<0.001). Use of RT decreased over time (57% to 18%, p<0.001) and use of chemotherapy remained stable (from 16% to 17%, p=0.344). Post-orchiectomy practice patterns remained relatively stable among patients with NSGCT: no treatment 29% to 41% (p=0.221); chemotherapy 69% to 55% (p=0.203); RPLND 27% to 26% (p=0.308). Among the 296 patients undergoing RPLND, 61% were performed in the post-chemotherapy setting; this proportion remained stable over time (p=0.423). OS for the entire cohort at 5 and 10 years was 96% and 94%. CSS at 5 and 10 years was 97% and 97%. There was no significant change in OS or CSS for seminoma (98% and 99% respectively) or NSGCT (96% and 96%) over the study period. CONCLUSIONS Since 2000 there has been de-escalation of treatment among men with seminoma, with surveillance alone predominating in recent years. Practice patterns for NSGCT have remained stable since 2000. Outcomes achieved in the general population are very good and have not decreased over time with de-escalation of therapy. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e197-e198 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Michael Leveridge More articles by this author D Robert Siemens More articles by this author Kelly Brennan More articles by this author Jason Izard More articles by this author Safiya Karim More articles by this author Christopher Booth 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 | 0,001 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,004 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 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 ».