Scandura et al identified pathologic findings predictive of metastatic testicular seminoma at the time of presentation. These can help to identify a patient who may require more aggressive management. The authors are from Barts Cancer Institute, Copenhagen University Hospital, Royal London Hospital and Barts NHS Trust.
Patient selection: testicular seminoma
Outcome: metastatic at presentation
Parameters from the multivariate analysis:
(1) diameter in millimeters
(2) invasion into the epididymis
Parameter
Finding
Points (Odds Ratio)
diameter
<= 42.5 mm
0
> 42.5 mm
1 (1.027 per mm)
invasion of epididymis
no
0
yes
1 (3.59)
number of predictors for metastasis being present =
= SUM(points for the 2 risk factors)
Interpretation:
• minimum number: 0
• maximum number: 2
• The risk for metastatic disease increases with the number of risk factors present.
Performance:
• The area under the ROC curve for diameter at the cutoff was 0.71.
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