Faber Kenneth D, Carlos Mari C T R, Cortessis Victoria K, Daneshmand Siamak
USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA.
Departments of Preventive Medicine and Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA.
Urol Oncol. 2014 Nov;32(8):1341-6. doi: 10.1016/j.urolonc.2014.04.004. Epub 2014 May 23.
To evaluate the accuracy of testicular germ cell tumor category in the Surveillance, Epidemiology, and End Results (SEER) database following the 2010 American Joint Committee of Cancer revision of the TNM staging criteria.
We performed a retrospective review of our testicular cancer database from January 2010 to July 2011. Registrar extracted data on 76 patients were entered into the Cancer Surveillance Program database from 2 hospitals. We reviewed the SEER coding for each patient, including T, N, M, and S and overall stage group, as well as the range and S value given for tumor markers (lactate dehydrogenase, beta-human chorionic gonadotropin, and α-fetoprotein) both preorchiectomy and postorchiectomy. We then compared these values with the actual staging and tumor markers determined by patient medical record review by a single urologist.
A high proportion of registry records were found to have inaccurate values of category: 71% of S category entries and 34% of N category entries, leading to an overall group stage inaccuracy of 77% in SEER data. Accuracy of overall combined stage group was significantly different between hospitals, with a higher percentage of errors at Hospital A (P< 0.05).
Despite improvements made to the SEER criteria for extracting data used to code testicular germ cell tumor TNM stage, considerable errors were identified, most notably in tumor marker and nodal status, resulting in an overwhelming number of errors in overall stage. Our findings suggest caution when utilizing SEER data for review of patients with testicular cancer and their staging.
在美国癌症联合委员会（AJCC）2010年修订TNM分期标准之后，评估监测、流行病学和最终结果（SEER）数据库中睾丸生殖细胞肿瘤分类的准确性。
我们对2010年1月至2011年7月期间的睾丸癌数据库进行了回顾性研究。登记员从2家医院提取了76例患者的数据并录入癌症监测项目数据库。我们查看了每位患者的SEER编码，包括T、N、M和S以及总体分期组，以及睾丸切除术前和术后肿瘤标志物（乳酸脱氢酶、β-人绒毛膜促性腺激素和甲胎蛋白）给出的范围和S值。然后，我们将这些值与由一名泌尿外科医生通过查阅患者病历确定的实际分期和肿瘤标志物进行比较。
发现登记记录中有很大一部分分类值不准确：71%的S分类条目和34%的N分类条目，导致SEER数据中总体分期组的不准确率达到77%。总体联合分期组的准确性在不同医院之间存在显著差异，A医院的错误百分比更高（P<0.05）。
尽管SEER用于编码睾丸生殖细胞肿瘤TNM分期的数据提取标准有所改进，但仍发现了相当多的错误，最明显的是肿瘤标志物和淋巴结状态方面的错误，导致总体分期出现大量错误。我们的研究结果表明，在利用SEER数据评估睾丸癌患者及其分期时应谨慎。
