Droz J P, Kramar A, Ghosn M, Piot G, Rey A, Theodore C, Wibault P, Court B H, Perrin J L, Travagli J P
Department of Medicine, Institut Gustave-Roussy, Ville-juif-France.
Cancer. 1988 Aug 1;62(3):564-8. doi: 10.1002/1097-0142(19880801)62:3<564::aid-cncr2820620321>3.0.co;2-a.
In order to define prognostic factors for advanced stage of nonseminomatous germ cell tumors (NSGCT) of the testis, the authors reviewed 84 patients treated from 1978 through 1985. The survival rate was 51% at 3 years. Patients with elevated seric levels of human chorionic gonadotropin (HCG) and/or alpha-fetoprotein (AFP), or the presence of an abdominal mass had significantly worse survival. Only HCG and AFP levels retained their significance when multivariate Cox analysis was performed. The probability that a patient achieves a complete remission (CR) was assessed by a function of certain patient characteristics using a multivariate logistic regression analysis. The significant variables were a function of HCG and AFP values. Since both variables are related to the CR rate and survival the authors define the obtention of a CR as a unique outcome of interest. The probability of a CR greater than 70% adequately separates the patients into two prognostic subgroups. This model currently is being used to enrole NSGCT patients in a prospective modulated clinical trial according to these prognostic factors.
为了确定睾丸非精原细胞瘤（NSGCT）晚期的预后因素，作者回顾了1978年至1985年期间接受治疗的84例患者。3年生存率为51%。血清人绒毛膜促性腺激素（HCG）和/或甲胎蛋白（AFP）水平升高或存在腹部肿块的患者生存率明显较差。进行多变量Cox分析时，只有HCG和AFP水平仍具有统计学意义。通过多变量逻辑回归分析，根据某些患者特征的函数评估患者实现完全缓解（CR）的概率。显著变量是HCG和AFP值的函数。由于这两个变量均与CR率和生存率相关，作者将获得CR定义为唯一感兴趣的结果。CR概率大于70%可将患者充分分为两个预后亚组。目前，该模型正用于根据这些预后因素将NSGCT患者纳入一项前瞻性调整临床试验。
