PROGNOSTIC FACTORS IN PATIENTS WITH PATHOLOGICAL STAGE-I NONSEMINOMATOUS TESTICULAR GERM-CELL TUMORS AND TUMOR RECURRENCE DURING FOLLOW-UP

Clinical staging in patients with stage I non-seminomatous germ cell t umors (NSGCTs) of the testis fails in 30% to correctly assess patholog ical stage since microscopic and small-volume retroperitoneal disease is not detectable on computed tomography of the abdomen. Patients stag ed by retroperitoneal lymph node dissection as pathological stage I in cur a distant (chest or serological) tumor relapse rate of 7-15% durin g follow-up. Recently, we reported on new risk factors as predictors o f pathological stage by flow cytometric DNA analysis in clinical stage I patients. These same methods were applied to a group of 14 patholog ical stage I patients who subsequently had either chest or serological recurrence. The findings in this group of patients were compared with those in a group of 47 pathological. stage I patients who did not exp erience recurrence. In pathological stage I NSGCT patients with distan t (chest or serological) tumor relapse, we found by histological evalu ation and DNA analysis of the original orchiectomy specimen proliferat ive tumor activity to be significantly predictive of relapse. Much as proliferative activity of the primary tumor is predictive of retroperi toneal metastasis, it may be a predictor of recurrence in pathological stage I patients.