Late relapse of testis cancer is more common than previously thought. Surgery is the preferred mode of therapy. Chemotherapy has only modest success in this entity, in contrast to the excellent results in de novo germ cell tumors. Patients treated for testicular germ cell cancer need annual follow-up evaluations throughout their life due to the possibility of late relapse.
Purpose:To develop a statistical model that predicts the histology (necrosis, mature teratoma, or cancer) after chemotherapy for metastatic nonseminomatous germ cell tumor (NSGCT).Patients and Methods: An international data set was collected comprising individual patient data from six study groups. Logistic regression analysis was used to estimate the probability of necrosis and the ratio of cancer and mature teratoma.Results: Of 556 patients, 250 (45%) had necrosis at resection, 236 (42%) had mature teratoma, and 70 (13%) had cancer. Predictors of necrosis were the absence of teratoma elements in the primary tumor, prechemotherapy normal alfa-fetoprotein (AFP), normal human chorionic gonadotropin (HCG), and elevated lactate dehydrogenase (LDH) levels, a small prechemotherapy or postchemotherapy mass, and a large shrinkage of the
Patients with persistently elevated AFP after orchiectomy should be treated initially with chemotherapy. Although the majority of patients with elevated serum HCG were disease-free after surgery alone, a fourth of these patients still had relapse and required chemotherapy.
America’s adult populace has failed to keep pace with the rapid inundation of science-centric knowledge affecting nearly every facet of personal, familial, and communal life. With three out of every four American adults considered scientifically illiterate, adult civic science literacy (CSL) has reached alarmingly low levels. The purpose of this research is to determine if the CSL of adults can be elevated through a renewed citizen science paradigm (RCSP)—incorporating nonformal outdoor adult education and structured experiential learning—in which volunteers conduct scientific research in an unfamiliar domain while maintaining the basic tenet of data collection in citizen science programming. From 67 program volunteers, 23 adults were purposively selected on the basis of their complete participation throughout the program. Data were collected through a repeated measures design, self-report surveys ( n = 23) and quantitatively analyzed. The results revealed the RCSP statistically significantly elevated the CSL—science vocabulary knowledge ( p < .001) and science process understanding ( p < .001)—of participating adults while collecting more than 30,000 pieces of scientific data for the supporting agency that funded the program.
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