Risk factors for relapse in stage I non-seminomatous germ-cell tumors: Preliminary results of the German Multicenter Trial

Risk factor analysis to identify low-risk patients far occult metastatic di sease (vascular invasion, percentage embryonal carcinoma, MIB-1 proliferati on rate) yields reliable results if performed by experts. A correct predict ion Is possible at the 90% level. Similar accuracy, however, may be achieve d if the computed tomography (CT) staging is optimized and the evaluation p erformed by an experienced investigator. The combination of both methods (b iological risk factor analysis and CT staging) may virtually exclude the ri sk of relapse in a limited number of patients. However, so far, no risk fac tor that is able to reliably predict occult metastatic disease or relapse i n clinical stage I patients has been identified in relapse in clinical stag e 1 patients has been identified in prospective trials. The preliminary res ults of the current German Multicenter Trial suggest an inferior value of p rediction for low-risk patients if risk factor analyis and/or CT staging is performed in non-specialized centers. :821999. (C) 1999 Wiley-Liss, Inc.