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Defining a New Prognostic Index for Stage I Nonseminomatous Germ Cell Tumors Using CXCL12 Expression and Proportion of Embryonal Carcinoma.
Gilbert, Duncan C; Al-Saadi, Reem; Thway, Khin; Chandler, Ian; Berney, Daniel; Gabe, Rhian; Stenning, Sally P; Sweet, Joan; Huddart, Robert; Shipley, Janet M.
Afiliação
  • Gilbert DC; Divisions of Molecular Pathology and Cancer Therapeutics, The Institute of Cancer Research, Sutton, Surrey, United Kingdom. MRC Clinical Trials Unit, Aviation House, London, United Kingdom.
  • Al-Saadi R; Divisions of Molecular Pathology and Cancer Therapeutics, The Institute of Cancer Research, Sutton, Surrey, United Kingdom.
  • Thway K; Divisions of Molecular Pathology and Cancer Therapeutics, The Institute of Cancer Research, Sutton, Surrey, United Kingdom.
  • Chandler I; Department of Histopathology, Royal Devon and Exeter Hospital, Exeter, United Kingdom.
  • Berney D; Barts Cancer Institute, Queen Mary, University of London, St Bartholomew's Hospital, London, United Kingdom.
  • Gabe R; The Hull York Medical School, University of York, Heslington, York, United Kingdom.
  • Stenning SP; MRC Clinical Trials Unit, Aviation House, London, United Kingdom.
  • Sweet J; Toronto General Hospital, Toronto, Ontario, Canada.
  • Huddart R; Department of Academic Radiotherapy and Oncology, Royal Marsden Hospitals NHS Foundation Trust, Sutton, Surrey, United Kingdom.
  • Shipley JM; Divisions of Molecular Pathology and Cancer Therapeutics, The Institute of Cancer Research, Sutton, Surrey, United Kingdom. janet.shipley@icr.ac.uk.
Clin Cancer Res ; 22(5): 1265-73, 2016 Mar 01.
Article em En | MEDLINE | ID: mdl-26453693
PURPOSE: Up to 50% of patients diagnosed with stage I nonseminomatous germ cell tumors (NSGCTs) harbor occult metastases. Patients are managed by surveillance with chemotherapy at relapse or adjuvant treatment up front. Late toxicities from chemotherapy are increasingly recognized. Based on a potential biologic role in germ cells/tumors and pilot data, our aim was to evaluate tumor expression of the chemokine CXCL12 alongside previously proposed markers as clinically useful biomarkers of relapse. EXPERIMENTAL DESIGN: Immunohistochemistry for tumor expression of CXCL12 was assessed as a biomarker of relapse alongside vascular invasion, histology (percentage embryonal carcinoma), and MIB1 staining for proliferation in formalin-fixed paraffin-embedded orchidectomy samples from patients enrolled in the Medical Research Council's TE08/22 prospective trials of surveillance in stage I NSGCTs. RESULTS: TE08/TE22 trial patients had a 76.4% 2-year relapse-free rate, and both CXCL12 expression and percentage embryonal carcinoma provided prognostic value independently of vascular invasion (stratified log rank test P = 0.006 for both). There was no additional prognostic value for MIB1 staining. A model using CXCL12, percentage embryonal carcinoma, and VI defines three prognostic groups that were independently validated. CONCLUSIONS: CXCL12 and percentage embryonal carcinoma both stratify patients' relapse risk over and above vascular invasion alone. This is anticipated to improve the stratification of patients and identify high-risk cases to be considered for adjuvant therapy.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias Testiculares / Biomarcadores Tumorais / Neoplasias Embrionárias de Células Germinativas / Quimiocina CXCL12 / Recidiva Local de Neoplasia Tipo de estudo: Etiology_studies / Prognostic_studies / Risk_factors_studies Limite: Humans / Male Idioma: En Ano de publicação: 2016 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias Testiculares / Biomarcadores Tumorais / Neoplasias Embrionárias de Células Germinativas / Quimiocina CXCL12 / Recidiva Local de Neoplasia Tipo de estudo: Etiology_studies / Prognostic_studies / Risk_factors_studies Limite: Humans / Male Idioma: En Ano de publicação: 2016 Tipo de documento: Article