Freedman L S, Parkinson M C, Jones W G, Oliver R T, Peckham M J, Read G, Newlands E S, Williams C J
Lancet. 1987 Aug 8;2(8554):294-8. doi: 10.1016/s0140-6736(87)90889-0.
259 patients with stage I non-seminomatous germ-cell testicular teratoma who were treated by orchidectomy alone and monitored at one often centres in the United Kingdom were followed for a median of 30 months. 62 of the 70 relapses occurred in the first 18 months after orchidectomy. The 2-year relapse-free rate was 74%, falling to 68% at 4 years. Histological sections from 233 of the orchidectomy specimens were reviewed centrally. Four features independently predicted relapses: invasion of testicular veins, invasion of testicular lymphatics, absence of yolk-sac elements, and presence of undifferentiated tumour. An index, based on the number of these features observed, identified a high-risk subgroup of 55 patients who had a 42% relapse-free rate at 2 years.
259例I期非精原细胞性睾丸生殖细胞畸胎瘤患者仅接受了睾丸切除术，并在英国的10个中心之一接受监测，随访时间中位数为30个月。70例复发患者中有62例在睾丸切除术后的前18个月内复发。2年无复发生存率为74%，4年时降至68%。对233例睾丸切除标本的组织学切片进行了集中复查。有4个特征可独立预测复发：睾丸静脉侵犯、睾丸淋巴管侵犯、卵黄囊成分缺失以及未分化肿瘤的存在。根据观察到的这些特征数量得出的一个指数，确定了一个由55例患者组成的高危亚组，该亚组2年无复发生存率为42%。
