Prognostic factors for relapse in stage I seminoma managed by surveillance: a pooled analysis: trial

Prognostic factors for relapse in stage I seminoma managed by surveillance: a pooled analysis

Needs review

Phase observationalN = 638

Population

Men with stage I seminoma managed by surveillance after orchidectomy

Design

Pooled analysis of individual patient data from the four largest surveillance studies (Princess Margaret Hospital, Danish Testicular Cancer Study Group, Royal Marsden Hospital and Royal London Hospital), 638 patients. Tumour size, histological subtype, rete testis invasion, small-vessel invasion (SVI) and age at diagnosis were analysed for prognostic importance.

Arms

Surveillance (experimental, n = 638): Orchidectomy then surveillance

People

Warde P

Relapse rateHR 2.0 (95% CI 1.3–3.2)Relapse rateHR 1.7 (95% CI 1.1–2.6)

Show the numbers

Results reported for Prognostic factors for relapse in stage I seminoma managed by surveillance: a pooled analysis
Endpoint	Analysis	Surveillance	Control	Effect
RFRAll pooled patients	primarymedian follow-up 7 yearsWarde 2002	82.3% at 5 y	—	121 relapses observed; follow-up range 0.02 to 17.5 years.
RFRPatients with tumour size 4 cm or less (univariate)	exploratoryWarde 2002	87%	—	P=0.003Univariate comparison with tumour size above 4 cm (RFR 76%); relapse-free rate time point not stated separately in this sentence.
RFRPatients with tumour size above 4 cm (univariate)	exploratoryWarde 2002	76%	—	P=0.003
RFRPatients without rete testis invasion (univariate)	exploratoryWarde 2002	86%	—	P=0.003
RFRPatients with rete testis invasion (univariate)	exploratoryWarde 2002	77%	—	P=0.003
RFRPatients without small-vessel invasion (univariate)	exploratoryWarde 2002	86%	—	P=0.038
RFRPatients with small-vessel invasion (univariate)	exploratoryWarde 2002	77%	—	P=0.038
Relapse rateMultivariate analysis, tumour size above 4 cm versus 4 cm or less	exploratoryWarde 2002	—	—	HR 2.0 (95% CI 1.3–3.2)Hazard ratio for relapse, tumour size above 4 cm versus 4 cm or less, as published.
Relapse rateMultivariate analysis, rete testis invasion present versus absent	exploratoryWarde 2002	—	—	HR 1.7 (95% CI 1.1–2.6)Hazard ratio for relapse with rete testis invasion, as published.

Results reported for Prognostic factors for relapse in stage I seminoma managed by surveillance: a pooled analysis
Endpoint	Analysis	Surveillance	Control	Effect
RFRAll pooled patients	primarymedian follow-up 7 yearsWarde 2002	82.3% at 5 y	—	121 relapses observed; follow-up range 0.02 to 17.5 years.
RFRPatients with tumour size 4 cm or less (univariate)	exploratoryWarde 2002	87%	—	P=0.003Univariate comparison with tumour size above 4 cm (RFR 76%); relapse-free rate time point not stated separately in this sentence.
RFRPatients with tumour size above 4 cm (univariate)	exploratoryWarde 2002	76%	—	P=0.003
RFRPatients without rete testis invasion (univariate)	exploratoryWarde 2002	86%	—	P=0.003
RFRPatients with rete testis invasion (univariate)	exploratoryWarde 2002	77%	—	P=0.003
RFRPatients without small-vessel invasion (univariate)	exploratoryWarde 2002	86%	—	P=0.038
RFRPatients with small-vessel invasion (univariate)	exploratoryWarde 2002	77%	—	P=0.038
Relapse rateMultivariate analysis, tumour size above 4 cm versus 4 cm or less	exploratoryWarde 2002	—	—	HR 2.0 (95% CI 1.3–3.2)Hazard ratio for relapse, tumour size above 4 cm versus 4 cm or less, as published.
Relapse rateMultivariate analysis, rete testis invasion present versus absent	exploratoryWarde 2002	—	—	HR 1.7 (95% CI 1.1–2.6)Hazard ratio for relapse with rete testis invasion, as published.

Hazard ratio (95% CI) by endpoint. Values below 1 favour the experimental arm.

Data table

Endpoint	HR	95% CI
Relapse rate	2	1.3–3.2
Relapse rate	1.7	1.1–2.6

Appears in

2002 Surveillance and risk-adapted management of stage I seminoma

Sources

Warde P, Specht L, Horwich A, Oliver T, Panzarella T, Gospodarowicz M, et al. Prognostic factors for relapse in stage I seminoma managed by surveillance: a pooled analysis. J Clin Oncol. 2002;20(22):4448-52.
PubMed DOI