ABSTRACT
Introducción El objetivo de este estudio fue evaluar el impacto del tamaño tumoral y la invasión de la rete testis en la supervivencia libre de progresión de nuestros pacientes con seminoma testicular en estadio I. También se llevó a cabo una revisión bibliográfica. Material y métodos Se realizó un estudio observacional retrospectivo incluyendo a los pacientes con seminoma en estadio I entre enero de 2010 y julio de 2022. Se compararon los pacientes sin factores de pronóstico favorable (Grupo A) con pacientes que presentaban factores de pronóstico desfavorable (Grupo B). Se utilizaron curvas de Kaplan-Meier y pruebas de log-rank para comparar la supervivencia libre de progresión (SLP) entre estos grupos. La significación estadística se consideró a p ≤ 0,05. Resultados Se incluyeron 55 pacientes en este estudio. Veinte pacientes (36,4%) tenían un pronóstico favorable (grupo A) y 35 (63,6%) presentaban factores de pronóstico desfavorable (grupo B). La edad media fue similar en ambos grupos (media ± desviación estándar), 38,62 ± 9,04 años. El tiempo medio de seguimiento fue de 63,5 ± 33,6 meses. Todos los pacientes del grupo A y 25,7% de los pacientes del grupo B se sometieron a vigilancia activa (VA). Veintiséis pacientes (74,3%) del grupo B fueron tratados con un ciclo de carboplatino adyuvante. Tres pacientes sufrieron recidiva en ganglios retroperitoneales (10,3%), todos tratados con tres ciclos de bleomicina, etopósido, y cisplatino (BEP), presentando remisión completa de la enfermedad. No se encontraron diferencias estadísticamente significativas en la SLP entre los grupos A y B (log-rank p = 0,317). Conclusiones La individualización del tratamiento adyuvante en el seminoma estadio I es esencial para evitar los efectos adversos derivados del mismo. (AU)
Introduction The aim of this study was to evaluate the impact of tumour size and rete testis invasion in progression free survival of our patients with stage I testicular seminoma. A literature review is also made. Material and methods A retrospective observational study was performed. We included patients with stage I seminoma between January 2010 and July 2022. Patients without factors of poor prognostic Group A were compared with patients with factors of poor prognostic Group B. Kaplan-Meier curves and log-rank testing were used to compare progression free survival (PFS) between these groups. Statistical significance was considered at P ≤ .05. Results 55 patients were included in this study. 20 patients (36.4%) were of good prognostic Group A and 35 (63.6%) had factors of poor prognostic Group B. The mean age was similar in both groups (mean ± standard deviation), 38.62 ± 9.04 years. The mean follow-up time was 63.5 ± 33.6 months. All the patients in group A and 25.7% of the patients in group B underwent active surveillance (AS). 26 patients (74.3%) of the patients in Group B were treated with one cycle of adyuvant carboplatin. Three patients suffered a relapse with retroperitoneal lymph nodes (10.3%), all of them were treated with three cycles of BEP, with a complete response of the disease. No statistical significant differences were found in PFS between Group A and B (log Rank P = .317). Conclusions Individualization of adjuvant treatment in stage I seminoma is important, avoiding the adverse effects derived from them. (AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Tumor Burden , Seminoma , Testicular Neoplasms , Retrospective Studies , Neoplasms, Germ Cell and Embryonal , CarboplatinABSTRACT
INTRODUCTION: The aim of this study was to evaluate the impact of tumour size and rete testis invasion in progression free survival of our patients with stage I testicular seminoma. A literature review is also made. MATERIAL AND METHODS: A retrospective observational study was performed. We included patients with stage I seminoma between January 2010 and July 2022. Patients without factors of poor prognostic -Group A- were compared with patients with factors of poor prognostic -Group B-. Kaplan-Meier curves and log-rank testing were used to compare progression free survival (PFS) between these groups. Statistical significance was considered at P≤.05. RESULTS: 55 patients were included in this study. 20 patients (36.4%) were of good prognostic -Group A- and 35 (63.6%) had factors of poor prognostic -Group B-. The mean age was similar in both groups (mean±standard deviation), 38.62±9.04 years. The mean follow-up time was 63.5±33.6 months. All the patients in group A and 25.7% of the patients in group B underwent active surveillance (AS). 26 patients (74.3%) of the patients in Group B were treated with one cycle of adyuvant carboplatin. Three patients suffered a relapse with retroperitoneal lymph nodes (10.3%), all of them were treated with three cycles of BEP, with a complete response of the disease. No statistical significant differences were found in PFS between Group A and B (log Rank P=.317). CONCLUSION: Individualization of adjuvant treatment in stage I seminoma is important, avoiding the adverse effects derived from them.
Subject(s)
Seminoma , Testicular Neoplasms , Male , Humans , Progression-Free Survival , Combined Modality Therapy , Seminoma/drug therapy , Seminoma/pathology , Rete Testis/pathology , Chemotherapy, Adjuvant , Disease-Free Survival , Testicular Neoplasms/therapy , Testicular Neoplasms/pathology , Neoplasm Staging , Neoplasm Recurrence, Local/epidemiology , Observational Studies as TopicABSTRACT
PURPOSE: This study aims to compare the ability of the PHI versus tPSA test to predict the presence of PCa in our population. METHODS: A prospective observational study was performed. We included patients with tPSA ≥ 2.5 ng/ml, biopsy naïve or previous negative biopsy, undergoing a blood test, which includes tPSA, fPSA, and p2PSA, and a prostate biopsy between March 2019 and March 2022. Patients with PCa found in the biopsy-Group A-were compared with patients with a negative biopsy result-Group B. Diagnostic accuracy of tPSA and PHI was assessed by receiver operating characteristic [ROC] curves and logistic regression. RESULTS: 140 men were included. Fifty-seven (40.7%) had a positive prostate biopsy result (Group A), and 83 (59.3%) had a negative biopsy result (Group B). The mean age was similar in both groups (mean ± standard deviation), 66.86 ± 6.61 years. No difference was found in the tPSA value between the groups (Group A PSA: 6.11 ng/ml (3.56-17.01); Group B: 6.42 ng/ml (2.46-19.45), p = 0.41). The mean value of PHI was statistically different between groups (Group A 65.50 (29-146) vs. Group B 48 (16-233), p = 0.0001). The area under the curve 0.44 for tPSA and 0.77 for PHI. The multivariate logistic regression model applied to PHI showed a significant increase in its predictive accuracy: 72.14% in the model without PHI, 76.09% with PHI. CONCLUSION: The PHI test improves PCa detection compared to tPSA in our population.
