1984
DOI: 10.1016/s0022-5347(17)50880-0 View full text |Buy / Rent full text
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Abstract: A preliminary study was conducted to correlate vascular invasion with metastasis in testicular tumors. A lectin-immunoperoxidase procedure was used to identify the vessels. Together with standard hematoxylin and eosin staining, the presence of tumor cells in vessels was detected. Primary tumor specimens from 37 cases and retroperitoneal lymph nodes from 10 cases of germ cell tumors were studied. The results showed good correlations between vascular invasion in primary tumors and metastasis to lymph nodes in no… Show more

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“…With regard to occult retroperitoneal disease, 84% of CSI patients were correctly classified as having pathologic Stage II disease if their primary NSGCT harbored ≥80% EC; the combination of ≥80% EC and presence of VI increased positive predictive values to 87%, underscoring the importance of EC as a prognostic risk factor in CSI disease. Therefore, only 13% of all CSI NSGCT patients would have undergone unnecessary RPLND, versus 70% of the patients if other clinical staging modalities were applied 5. Although these data must be confirmed in a prospective randomized clinical trial, the 100% positive prediction rate for our first 10 prospective consecutive CSI NSGCT patients to whom we applied our cutoff points is extremely encouraging.…”
Section: Discussionmentioning
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“…With regard to occult retroperitoneal disease, 84% of CSI patients were correctly classified as having pathologic Stage II disease if their primary NSGCT harbored ≥80% EC; the combination of ≥80% EC and presence of VI increased positive predictive values to 87%, underscoring the importance of EC as a prognostic risk factor in CSI disease. Therefore, only 13% of all CSI NSGCT patients would have undergone unnecessary RPLND, versus 70% of the patients if other clinical staging modalities were applied 5. Although these data must be confirmed in a prospective randomized clinical trial, the 100% positive prediction rate for our first 10 prospective consecutive CSI NSGCT patients to whom we applied our cutoff points is extremely encouraging.…”
Section: Discussionmentioning
“…In previous studies, vascular invasion and the percentage of embryonal carcinoma in an orchiectomy specimen have been identified as significant histopathologic risk factors for pathologic Stage II disease 5‐14. The addition of DNA flow cytometry15 and immunohistochemical assessment of proliferation markers such as proliferating cell nuclear antigen (PCNA),16 MIB‐1,17, 18 and p5319, 20 to these histopathologic features sometimes did not improve assessment of the probability of predicting lymph node involvement,15, 16, 19, 20 and at other times the data reported were contradictory, making a final decision on their clinical utility impossible 17, 18…”
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“…7,8 Vascular invasion has been pointed out as such a marker in various studies, an idea first suggested by Raghavan et al 9 and Peckam et al 10 The presence of vascular invasion is associated with poor prognosis, relapse, and metastases, particularly in nonseminomas. 5,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] The relevance of vascular invasion in testicular germ cell tumors is illustrated by its inclusion in the TNM staging system, resulting in a pT2. 26 Given this clinical importance, strict criteria for establishing the diagnosis of vascular invasion are recommended by expert panels, as some representations may result in overdiagnosis and, hence, possible overtreatment of patients.…”
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“…5 Although these data must be confirmed in a prospective randomized clinical trial, the 100% positive prediction rate for our first 10 prospective consecutive CSI NSGCT patients to whom we applied our cutoff points is extremely encouraging. We were able to develop reliable cutoff points for %EC that predicted pathologic stage with a 90% accuracy, thereby making possibly a riskadapted therapeutic approach to CSI NSGCT.…”
Section: Discussionmentioning
“…Paraffin embedded, formalin fixed tissue blocks (3)(4)(5) from the primary tumor were available for all 149 patients. Histopathologic review of the H&E-stained slides for these cases was performed by a single pathologist who was blinded to the stage of disease.…”
Section: Methodsmentioning