Relapse in children with clinical stage I testicular yolk sac tumors after initial orchiectomy

Chemotherapy burden of risk-adapted treatment verse surveillance for clinical stage I pediatric testicular cancer: A decision tree model analysis

“…Meanwhile, necrosis, the new predictor of tumor relapse, combined with LVI stratified patients into 2 groups, and the relapse rates were 73% and 17%, respectively. (6) In other studies, the relapse of high-risk group was 0.38-0.55, and the relapse of low-risk group was 0.16-0.19. (9,12,(14)(15)(16)(17)(18)(19)(20) Based on these data, we evaluated that the chemotherapy exposure was lower in risk-adapted treatment in our model.…”

“…(21) In some studies, primary chemotherapy was associated with an extremely low relapse rate, and it decreased relapse rate in the high-risk group significantly. (6) So we used decision analysis to develop a model to evaluate the chemotherapy exposure between two protocols. Risk-adapted management might reduce the exposure of 6 chemotherapy by primary chemotherapy for high-risk patients.…”

“…According to recent studies, the overall survival of CS1 pediatric testicular cancer was nearly 100% with system chemotherapy, and progression rates after primary and salvage chemotherapy both were about 5% (2.3-6.8%) ( Table 1). (6,9,12,(14)(15)(16)(17)(18)(19)(20) And rare operation or radiation after chemotherapy was reported. Based on these studies, we defined relapse rates of high and lowrisk patients who underwent surveillance were 0.60 (0.38-0.73) and 0.15 (0.10-0.20), respectively; the proportion of low-risk patients was from 0-1, progression rates after primary and salvage chemotherapy were both 0.05 (0.01-0.10), and second line chemotherapy was the last treatment with a 100% success rate (as shown in Figure 1 and Table 1).…”

“…Based on these studies, we defined relapse rates of high and lowrisk patients who underwent surveillance were 0.60 (0.38-0.73) and 0.15 (0.10-0.20), respectively; the proportion of low-risk patients was from 0-1, progression rates after primary and salvage chemotherapy were both 0.05 (0.01-0.10), and second line chemotherapy was the last treatment with a 100% success rate (as shown in Figure 1 and Table 1). (6,9,12,(14)(15)(16)(17)(18)(19)(20) To evaluate treatment-related toxicity between first-line and second-line chemotherapy, digital values were obtained in an interview with urological oncologists. Before the interview, the consensus of short…”

“…(1)(2)(3)(4)(5)(6) And 70% to 80% patients have clinical stage Ⅰ (CS1) disease, for its hematogenous predilection of metastasis in children, primary retroperitoneal lymph node dissection (RPLND) was not recommended for CS1 yolk sac tumor. (1,(6)(7) In the recent summary of PDQ Pediatric Treatment Editorial Board and recommendation of POG/CCG, surveillance was recommended for children with CS1 testicular cancer after radical inguinal orchiectomy (RIO). (8)(9) In recent studies, about 20% of children with CS1 testicular germ cell tumors (GCT) suffered a relapse 3 in 4 years after RIO and underwent 3-4 cycles of salvage chemotherapy.…”