I commend the authors for studying clinical stage I testis germ cell tumor (TGCT)
to identify predictors for relapse during surveillance and I appreciate the challenges
that come with analyzing clinical management of a relatively rare disease [
[1]
]. Nonetheless, potential biases should be considered when interpreting the results.
The authors analyzed multiple data points (age and pT stage at diagnosis, tumor markers
and pathology specimen characteristics) to determine which, if any, affect risk of
relapse, development of secondary malignant neoplasm or death during surveillance.
Surveillance protocols were not the same for all patients, which the authors acknowledged
is a potential selection bias. Of the data points analyzed, only age and AFP level
were available for all 106 patients. Tumor pT stage was unknown in 27 percent, beta-HCG
unknown in 46 percent and histology unknown in 25 percent of the study population.
The authors explained the incidences of unknown, stating that in order to maintain
statistical integrity they reported “unknown” unless the full complement of pathologic
variables was available. But missing data for a large proportion of a study population
could bias results, regardless of the reason for the data missing.To read this article in full you will need to make a payment
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References
- Clinicopathologic predictors of outcomes in children with Stage I testicular germ cell tumors: a pooled post hoc analysis of trials from the Children's Oncology Group.J Pediatr Urol. 2022; 18: 505-511
- Surveillance after initial surgery for Stage I pediatric and adolescent boys with malignant testicular germ cell tumors: Report from the Children's Oncology Group.J Pediatr Surg. 2015; 50: 1000-1003
Article info
Publication history
Published online: July 07, 2022
Accepted:
May 22,
2022
Received:
May 20,
2022
Identification
Copyright
© 2022 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Response to commentary re: Clinicopathologic predictors of outcomes in children with stage I testicular germ cell tumors: A pooled post hoc analysis of trials from the Children's oncology groupJournal of Pediatric UrologyVol. 18Issue 4
- PreviewPediatric and adolescent patients with testicular germ cell tumors (TGCT) are a particularly challenging population to study given the relatively uncommon incidence of TGCT in children. Unlike in adults, there are no reliable prognostic features to individualize risk of relapse among children with low-stage TGCT. Given this pressing clinical need, herein we leveraged data from three prospective cooperative trials to identify clinicopathologic features predictive for relapse in children with stage I TGCT.
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