Universität zu Köln

Strauch, Angelina ORCID: 0009-0000-9077-0946, Schoch, Justine, Hellmich, Martin ORCID: 0000-0001-5174-928X, Schmelz, Hans and Nestler, Tim ORCID: 0000-0001-6033-6364 (2026). Assessment of new prognostic risk models for recurrence in patients with clinical stage I seminoma. BJU International, 137 (1). pp. 138-145. Wiley. ISSN 1464-4096

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Abstract

Objectives: To evaluate two new prognostic risk models aimed at improving clinical decision‐making in patients with clinical stage (cS) I seminomatous testicular germ cell tumours (GCTs), 5%–30% of whom experience recurrence during surveillance after orchiectomy and may benefit from adjuvant therapy. Methods: In this exploratory study, patients with unilateral cS I seminoma, normalised serum tumour markers after orchiectomy, no adjuvant therapy and at least 12 months of follow‐up were included. Cox regression analysis was applied to evaluate the prognostic factors proposed by the Danish Testicular Cancer Database (DaTeCa) and the European Association of Urology (EAU), and recurrence probabilities were estimated using the Kaplan–Meier method. Results: Among 139 patients, 25 (18%) experienced recurrence within a median follow‐up of 37 months (95% confidence interval 47.9–63.1 months). Multivariable analysis confirmed only rete testis infiltration as an independent predictor of recurrence ( P = 0.039), while other prognostic factors included in the DaTeCa risk model (i.e. hilar soft tissue invasion, rete testis infiltration, lymphovascular invasion, and elevated pre‐orchiectomy human chorionic gonadotropin and lactate dehydrogenase) and the EAU model (i.e. tumour size, rete testis infiltration and lymphovascular invasion) were not. However, 5‐year recurrence risks for the different risk groups, defined by the combination of prognostic factors, aligned well with the DaTeCa (no risk factors: 4% vs 6%; all risk factors: 67% vs 62%) and the EAU risk models (low [13% vs 8%] and intermediate risk [22% vs 20%]). A discrepancy was observed in EAU high‐risk cases (67% vs 44%), which was probably attributable to the very small number of patients in our high‐risk subgroup ( n = 6 [4.3%]). Conclusion: The DaTeCa and EAU risk classification models demonstrated overall consistency in our exploratory cohort and may aid in identifying patients with cS I seminoma who are at high risk for recurrence and who might be candidates for adjuvant therapy. Further multicentre validation studies are needed.

Item Type:	Article
Creators:	Creators Email ORCID ORCID Put Code Strauch, Angelina UNSPECIFIED https://orcid.org/0009-0000-9077-0946 UNSPECIFIED Schoch, Justine UNSPECIFIED UNSPECIFIED UNSPECIFIED Hellmich, Martin UNSPECIFIED https://orcid.org/0000-0001-5174-928X UNSPECIFIED Schmelz, Hans UNSPECIFIED UNSPECIFIED UNSPECIFIED Nestler, Tim UNSPECIFIED https://orcid.org/0000-0001-6033-6364 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-802360
Identification Number:	10.1111/bju.70041
Journal or Publication Title:	BJU International
Volume:	137
Number:	1
Page Range:	pp. 138-145
Number of Pages:	8
Date:	19 January 2026
Publisher:	Wiley
ISSN:	1464-4096
Language:	English
Faculty:	Faculty of Medicine
Divisions:	Faculty of Medicine > Medizinische Statistik und Bioinformatik Faculty of Medicine > Urologie > Klinik und Poliklinik für Urologie
Subjects:	General statistics Life sciences Medical sciences Medicine
Uncontrolled Keywords:	Keywords Language germ cell tumour ; testicular cancer ; seminoma, risk stratification ; prognostic factors ; adjuvant therapy ; overtreatment English
['eprint_fieldname_oa_funders' not defined]:	Publikationsfonds UzK
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/80236