The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
John P Donohue - One of the best experts on this subject based on the ideXlab platform.
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residual pulmonary masses after chemotherapy for metastatic nonseminomatous germ cell tumor prediction of histology
Cancer, 1997Co-Authors: Ewout W Steyerberg, Dirk Sleijfer, Heimen Schraffordt Koops, Sophie D Fossa, Guy C Toner, Jonathan E Messemer, John P Donohue, Jan H Keizer, A Gerl, Dik J F HabbemaAbstract:BACKGROUND After chemotherapy for a metastatic nonseminomatous germ cell tumor, pulmonary masses may be seen on a computed tomography scan. These residual masses may contain one of three histologic elements: necrosis, Mature Teratoma, or cancer. Because surgical resection of masses containing only necrosis is unnecessary, the authors aimed to predict the histology of these residual masses. METHODS Six study groups contributed patient data on a total of 215 patients undergoing thoracotomy after cisplatin-based induction chemotherapy for metastatic testicular nonseminomatous germ cell tumors. Logistic regression analysis was used to estimate the probability of necrosis, Mature Teratoma, and cancer in relation to predictors known before thoracotomy. RESULTS The pulmonary mass histology was necrosis in 116 patients (54%), Mature Teratoma in 70 (33%), and cancer in 29 (13%). Necrosis was found at thoracotomy in 89% of those patients with necrosis at retroperitoneal lymph node dissection (RPLND). Other predictors included the primary tumor histology, prechemotherapy tumor marker levels, change in mass size during chemotherapy, and the presence of a single, unilateral mass. Multivariate combination of predictors yielded reliable models (goodness-of-fit tests, P > 0.20), which discriminated necrosis well from other histologies, especially if RPLND histology was available (area under the receiver operating characteristic curve, 0.86). CONCLUSIONS This analysis indicated subgroups of patients with a high probability of necrosis and a low risk of cancer for whom close follow-up of the residual pulmonary mass might be considered. In most patients, a RPLND should be performed before a thoracotomy is considered, because the probability of necrosis is generally higher at thoracotomy than at RPLND and the histology at RPLND is a strong predictor of the histology at thoracotomy. Cancer 1997; 79:345-55. © 1997 American Cancer Society.
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prediction of residual retroperitoneal mass histology after chemotherapy for metastatic nonseminomatous germ cell tumor multivariate analysis of individual patient data from six study groups
Journal of Clinical Oncology, 1995Co-Authors: Ewout W Steyerberg, H J Keizer, Sophie D Fossa, D T Sleijfer, Guy C Toner, Schraffordt H Koops, P F Mulders, Jonathan E Messemer, John P DonohueAbstract:PURPOSE: To develop a statistical model that predicts the histology (necrosis, Mature Teratoma, or cancer) after chemotherapy for metastatic nonseminomatous germ cell tumor (NSGCT). PATIENTS AND METHODS: An international data set was collected comprising individual patient data from six study groups. Logistic regression analysis was used to estimate the probability of necrosis and the ratio of cancer and Mature Teratoma. RESULTS: Of 556 patients, 250 (45%) had necrosis at resection, 236 (42%) had Mature Teratoma, and 70 (13%) had cancer. Predictors of necrosis were the absence of Teratoma elements in the primary tumor, prechemotherapy normal alfa-fetoprotein (AFP), normal human chorionic gonadotropin (HCG), and elevated lactate dehydrogenase (LDH) levels, a small prechemotherapy or postchemotherapy mass, and a large shrinkage of the mass during chemotherapy. Multivariate combination of predictors yielded reliable models (goodness-of-fit tests, P > .20), which discriminated necrosis well from other histologies (area under the receiver operating characteristic (ROC) curve, .84), but which discriminated cancer only reasonably from Mature Teratoma (area, .66). Internal and external validation confirmed these findings. CONCLUSION: The validated models estimate with high accuracy the histology at resection, especially necrosis, based on well-known and readily available predictors. The predicted probabilities may help to choose between immediate resection of a residual mass or follow-up, taking into account the expected benefits and risks of resection, feasibility of frequent follow-up, the financial costs, and the patient's individual preferences.
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prediction of residual retroperitoneal mass histology after chemotherapy for metastatic nonseminomatous germ cell tumor multivariate analysis of individual patient data from six study groups
Journal of Clinical Oncology, 1995Co-Authors: Ewout W Steyerberg, H J Keizer, Sophie D Fossa, D T Sleijfer, Guy C Toner, Schraffordt H Koops, P F Mulders, Jonathan E Messemer, K Ney, John P DonohueAbstract:PURPOSETo develop a statistical model that predicts the histology (necrosis, Mature Teratoma, or cancer) after chemotherapy for metastatic nonseminomatous germ cell tumor (NSGCT).PATIENTS AND METHODSAn international data set was collected comprising individual patient data from six study groups. Logistic regression analysis was used to estimate the probability of necrosis and the ratio of cancer and Mature Teratoma.RESULTSOf 556 patients, 250 (45%) had necrosis at resection, 236 (42%) had Mature Teratoma, and 70 (13%) had cancer. Predictors of necrosis were the absence of Teratoma elements in the primary tumor, prechemotherapy normal alfa-fetoprotein (AFP), normal human chorionic gonadotropin (HCG), and elevated lactate dehydrogenase (LDH) levels, a small prechemotherapy or postchemotherapy mass, and a large shrinkage of the mass during chemotherapy. Multivariate combination of predictors yielded reliable models (goodness-of-fit tests, P > .20), which discriminated necrosis well from other histologies (ar...
Ewout W Steyerberg - One of the best experts on this subject based on the ideXlab platform.
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residual pulmonary masses after chemotherapy for metastatic nonseminomatous germ cell tumor prediction of histology
Cancer, 1997Co-Authors: Ewout W Steyerberg, Dirk Sleijfer, Heimen Schraffordt Koops, Sophie D Fossa, Guy C Toner, Jonathan E Messemer, John P Donohue, Jan H Keizer, A Gerl, Dik J F HabbemaAbstract:BACKGROUND After chemotherapy for a metastatic nonseminomatous germ cell tumor, pulmonary masses may be seen on a computed tomography scan. These residual masses may contain one of three histologic elements: necrosis, Mature Teratoma, or cancer. Because surgical resection of masses containing only necrosis is unnecessary, the authors aimed to predict the histology of these residual masses. METHODS Six study groups contributed patient data on a total of 215 patients undergoing thoracotomy after cisplatin-based induction chemotherapy for metastatic testicular nonseminomatous germ cell tumors. Logistic regression analysis was used to estimate the probability of necrosis, Mature Teratoma, and cancer in relation to predictors known before thoracotomy. RESULTS The pulmonary mass histology was necrosis in 116 patients (54%), Mature Teratoma in 70 (33%), and cancer in 29 (13%). Necrosis was found at thoracotomy in 89% of those patients with necrosis at retroperitoneal lymph node dissection (RPLND). Other predictors included the primary tumor histology, prechemotherapy tumor marker levels, change in mass size during chemotherapy, and the presence of a single, unilateral mass. Multivariate combination of predictors yielded reliable models (goodness-of-fit tests, P > 0.20), which discriminated necrosis well from other histologies, especially if RPLND histology was available (area under the receiver operating characteristic curve, 0.86). CONCLUSIONS This analysis indicated subgroups of patients with a high probability of necrosis and a low risk of cancer for whom close follow-up of the residual pulmonary mass might be considered. In most patients, a RPLND should be performed before a thoracotomy is considered, because the probability of necrosis is generally higher at thoracotomy than at RPLND and the histology at RPLND is a strong predictor of the histology at thoracotomy. Cancer 1997; 79:345-55. © 1997 American Cancer Society.
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prediction of residual retroperitoneal mass histology after chemotherapy for metastatic nonseminomatous germ cell tumor multivariate analysis of individual patient data from six study groups
Journal of Clinical Oncology, 1995Co-Authors: Ewout W Steyerberg, H J Keizer, Sophie D Fossa, D T Sleijfer, Guy C Toner, Schraffordt H Koops, P F Mulders, Jonathan E Messemer, John P DonohueAbstract:PURPOSE: To develop a statistical model that predicts the histology (necrosis, Mature Teratoma, or cancer) after chemotherapy for metastatic nonseminomatous germ cell tumor (NSGCT). PATIENTS AND METHODS: An international data set was collected comprising individual patient data from six study groups. Logistic regression analysis was used to estimate the probability of necrosis and the ratio of cancer and Mature Teratoma. RESULTS: Of 556 patients, 250 (45%) had necrosis at resection, 236 (42%) had Mature Teratoma, and 70 (13%) had cancer. Predictors of necrosis were the absence of Teratoma elements in the primary tumor, prechemotherapy normal alfa-fetoprotein (AFP), normal human chorionic gonadotropin (HCG), and elevated lactate dehydrogenase (LDH) levels, a small prechemotherapy or postchemotherapy mass, and a large shrinkage of the mass during chemotherapy. Multivariate combination of predictors yielded reliable models (goodness-of-fit tests, P > .20), which discriminated necrosis well from other histologies (area under the receiver operating characteristic (ROC) curve, .84), but which discriminated cancer only reasonably from Mature Teratoma (area, .66). Internal and external validation confirmed these findings. CONCLUSION: The validated models estimate with high accuracy the histology at resection, especially necrosis, based on well-known and readily available predictors. The predicted probabilities may help to choose between immediate resection of a residual mass or follow-up, taking into account the expected benefits and risks of resection, feasibility of frequent follow-up, the financial costs, and the patient's individual preferences.
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prediction of residual retroperitoneal mass histology after chemotherapy for metastatic nonseminomatous germ cell tumor multivariate analysis of individual patient data from six study groups
Journal of Clinical Oncology, 1995Co-Authors: Ewout W Steyerberg, H J Keizer, Sophie D Fossa, D T Sleijfer, Guy C Toner, Schraffordt H Koops, P F Mulders, Jonathan E Messemer, K Ney, John P DonohueAbstract:PURPOSETo develop a statistical model that predicts the histology (necrosis, Mature Teratoma, or cancer) after chemotherapy for metastatic nonseminomatous germ cell tumor (NSGCT).PATIENTS AND METHODSAn international data set was collected comprising individual patient data from six study groups. Logistic regression analysis was used to estimate the probability of necrosis and the ratio of cancer and Mature Teratoma.RESULTSOf 556 patients, 250 (45%) had necrosis at resection, 236 (42%) had Mature Teratoma, and 70 (13%) had cancer. Predictors of necrosis were the absence of Teratoma elements in the primary tumor, prechemotherapy normal alfa-fetoprotein (AFP), normal human chorionic gonadotropin (HCG), and elevated lactate dehydrogenase (LDH) levels, a small prechemotherapy or postchemotherapy mass, and a large shrinkage of the mass during chemotherapy. Multivariate combination of predictors yielded reliable models (goodness-of-fit tests, P > .20), which discriminated necrosis well from other histologies (ar...
Masao Matsutani - One of the best experts on this subject based on the ideXlab platform.
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successful treatment of mixed yolk sac tumor and Mature Teratoma in the spinal cord case report
Journal of Neurosurgery, 2017Co-Authors: Akitake Mukasa, Shunsuke Yanagisawa, Kuniaki Saito, Shota Tanaka, Keisuke Takai, Junji Shibahara, Masachika Ikegami, Yusuke Nakao, Katsushi Takeshita, Masao MatsutaniAbstract:Primary spinal germ cell tumors are rare, and spinal nongerminomatous germ cell tumors represent an even rarer subset for which no standard therapy has been established. The authors report the case of a 24-year-old woman with multifocal primary spinal germ cell tumors scattered from T-12 to L-5 that consisted of yolk sac tumor and Mature Teratoma. After diagnostic partial resection, the patient was treated with 30 Gy of craniospinal irradiation and 30 Gy of local spinal irradiation, followed by 8 courses of chemotherapy based on ifosfamide, cisplatin, and etoposide (ICE). Salvage surgery was also performed for residual Mature Teratoma components after the third course of ICE chemotherapy. Chemotherapy was continued after the operation, but ifosfamide was entirely eliminated from the ICE regimen because severe myelosuppression was observed after previous courses. The patient remains recurrence free as of more than 5 years after the completion of chemotherapy. This case suggests that this treatment strategy...
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successful treatment of mixed yolk sac tumor and Mature Teratoma in the spinal cord case report
Journal of Neurosurgery, 2017Co-Authors: Akitake Mukasa, Shunsuke Yanagisawa, Kuniaki Saito, Shota Tanaka, Keisuke Takai, Junji Shibahara, Masachika Ikegami, Yusuke Nakao, Katsushi Takeshita, Masao MatsutaniAbstract:Primary spinal germ cell tumors are rare, and spinal nongerminomatous germ cell tumors represent an even rarer subset for which no standard therapy has been established. The authors report the case of a 24-year-old woman with multifocal primary spinal germ cell tumors scattered from T-12 to L-5 that consisted of yolk sac tumor and Mature Teratoma. After diagnostic partial resection, the patient was treated with 30 Gy of craniospinal irradiation and 30 Gy of local spinal irradiation, followed by 8 courses of chemotherapy based on ifosfamide, cisplatin, and etoposide (ICE). Salvage surgery was also performed for residual Mature Teratoma components after the third course of ICE chemotherapy. Chemotherapy was continued after the operation, but ifosfamide was entirely eliminated from the ICE regimen because severe myelosuppression was observed after previous courses. The patient remains recurrence free as of more than 5 years after the completion of chemotherapy. This case suggests that this treatment strategy is an effective option for primary spinal yolk sac tumor.
Jonathan E Messemer - One of the best experts on this subject based on the ideXlab platform.
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residual pulmonary masses after chemotherapy for metastatic nonseminomatous germ cell tumor prediction of histology
Cancer, 1997Co-Authors: Ewout W Steyerberg, Dirk Sleijfer, Heimen Schraffordt Koops, Sophie D Fossa, Guy C Toner, Jonathan E Messemer, John P Donohue, Jan H Keizer, A Gerl, Dik J F HabbemaAbstract:BACKGROUND After chemotherapy for a metastatic nonseminomatous germ cell tumor, pulmonary masses may be seen on a computed tomography scan. These residual masses may contain one of three histologic elements: necrosis, Mature Teratoma, or cancer. Because surgical resection of masses containing only necrosis is unnecessary, the authors aimed to predict the histology of these residual masses. METHODS Six study groups contributed patient data on a total of 215 patients undergoing thoracotomy after cisplatin-based induction chemotherapy for metastatic testicular nonseminomatous germ cell tumors. Logistic regression analysis was used to estimate the probability of necrosis, Mature Teratoma, and cancer in relation to predictors known before thoracotomy. RESULTS The pulmonary mass histology was necrosis in 116 patients (54%), Mature Teratoma in 70 (33%), and cancer in 29 (13%). Necrosis was found at thoracotomy in 89% of those patients with necrosis at retroperitoneal lymph node dissection (RPLND). Other predictors included the primary tumor histology, prechemotherapy tumor marker levels, change in mass size during chemotherapy, and the presence of a single, unilateral mass. Multivariate combination of predictors yielded reliable models (goodness-of-fit tests, P > 0.20), which discriminated necrosis well from other histologies, especially if RPLND histology was available (area under the receiver operating characteristic curve, 0.86). CONCLUSIONS This analysis indicated subgroups of patients with a high probability of necrosis and a low risk of cancer for whom close follow-up of the residual pulmonary mass might be considered. In most patients, a RPLND should be performed before a thoracotomy is considered, because the probability of necrosis is generally higher at thoracotomy than at RPLND and the histology at RPLND is a strong predictor of the histology at thoracotomy. Cancer 1997; 79:345-55. © 1997 American Cancer Society.
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prediction of residual retroperitoneal mass histology after chemotherapy for metastatic nonseminomatous germ cell tumor multivariate analysis of individual patient data from six study groups
Journal of Clinical Oncology, 1995Co-Authors: Ewout W Steyerberg, H J Keizer, Sophie D Fossa, D T Sleijfer, Guy C Toner, Schraffordt H Koops, P F Mulders, Jonathan E Messemer, John P DonohueAbstract:PURPOSE: To develop a statistical model that predicts the histology (necrosis, Mature Teratoma, or cancer) after chemotherapy for metastatic nonseminomatous germ cell tumor (NSGCT). PATIENTS AND METHODS: An international data set was collected comprising individual patient data from six study groups. Logistic regression analysis was used to estimate the probability of necrosis and the ratio of cancer and Mature Teratoma. RESULTS: Of 556 patients, 250 (45%) had necrosis at resection, 236 (42%) had Mature Teratoma, and 70 (13%) had cancer. Predictors of necrosis were the absence of Teratoma elements in the primary tumor, prechemotherapy normal alfa-fetoprotein (AFP), normal human chorionic gonadotropin (HCG), and elevated lactate dehydrogenase (LDH) levels, a small prechemotherapy or postchemotherapy mass, and a large shrinkage of the mass during chemotherapy. Multivariate combination of predictors yielded reliable models (goodness-of-fit tests, P > .20), which discriminated necrosis well from other histologies (area under the receiver operating characteristic (ROC) curve, .84), but which discriminated cancer only reasonably from Mature Teratoma (area, .66). Internal and external validation confirmed these findings. CONCLUSION: The validated models estimate with high accuracy the histology at resection, especially necrosis, based on well-known and readily available predictors. The predicted probabilities may help to choose between immediate resection of a residual mass or follow-up, taking into account the expected benefits and risks of resection, feasibility of frequent follow-up, the financial costs, and the patient's individual preferences.
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prediction of residual retroperitoneal mass histology after chemotherapy for metastatic nonseminomatous germ cell tumor multivariate analysis of individual patient data from six study groups
Journal of Clinical Oncology, 1995Co-Authors: Ewout W Steyerberg, H J Keizer, Sophie D Fossa, D T Sleijfer, Guy C Toner, Schraffordt H Koops, P F Mulders, Jonathan E Messemer, K Ney, John P DonohueAbstract:PURPOSETo develop a statistical model that predicts the histology (necrosis, Mature Teratoma, or cancer) after chemotherapy for metastatic nonseminomatous germ cell tumor (NSGCT).PATIENTS AND METHODSAn international data set was collected comprising individual patient data from six study groups. Logistic regression analysis was used to estimate the probability of necrosis and the ratio of cancer and Mature Teratoma.RESULTSOf 556 patients, 250 (45%) had necrosis at resection, 236 (42%) had Mature Teratoma, and 70 (13%) had cancer. Predictors of necrosis were the absence of Teratoma elements in the primary tumor, prechemotherapy normal alfa-fetoprotein (AFP), normal human chorionic gonadotropin (HCG), and elevated lactate dehydrogenase (LDH) levels, a small prechemotherapy or postchemotherapy mass, and a large shrinkage of the mass during chemotherapy. Multivariate combination of predictors yielded reliable models (goodness-of-fit tests, P > .20), which discriminated necrosis well from other histologies (ar...
Guy C Toner - One of the best experts on this subject based on the ideXlab platform.
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residual pulmonary masses after chemotherapy for metastatic nonseminomatous germ cell tumor prediction of histology
Cancer, 1997Co-Authors: Ewout W Steyerberg, Dirk Sleijfer, Heimen Schraffordt Koops, Sophie D Fossa, Guy C Toner, Jonathan E Messemer, John P Donohue, Jan H Keizer, A Gerl, Dik J F HabbemaAbstract:BACKGROUND After chemotherapy for a metastatic nonseminomatous germ cell tumor, pulmonary masses may be seen on a computed tomography scan. These residual masses may contain one of three histologic elements: necrosis, Mature Teratoma, or cancer. Because surgical resection of masses containing only necrosis is unnecessary, the authors aimed to predict the histology of these residual masses. METHODS Six study groups contributed patient data on a total of 215 patients undergoing thoracotomy after cisplatin-based induction chemotherapy for metastatic testicular nonseminomatous germ cell tumors. Logistic regression analysis was used to estimate the probability of necrosis, Mature Teratoma, and cancer in relation to predictors known before thoracotomy. RESULTS The pulmonary mass histology was necrosis in 116 patients (54%), Mature Teratoma in 70 (33%), and cancer in 29 (13%). Necrosis was found at thoracotomy in 89% of those patients with necrosis at retroperitoneal lymph node dissection (RPLND). Other predictors included the primary tumor histology, prechemotherapy tumor marker levels, change in mass size during chemotherapy, and the presence of a single, unilateral mass. Multivariate combination of predictors yielded reliable models (goodness-of-fit tests, P > 0.20), which discriminated necrosis well from other histologies, especially if RPLND histology was available (area under the receiver operating characteristic curve, 0.86). CONCLUSIONS This analysis indicated subgroups of patients with a high probability of necrosis and a low risk of cancer for whom close follow-up of the residual pulmonary mass might be considered. In most patients, a RPLND should be performed before a thoracotomy is considered, because the probability of necrosis is generally higher at thoracotomy than at RPLND and the histology at RPLND is a strong predictor of the histology at thoracotomy. Cancer 1997; 79:345-55. © 1997 American Cancer Society.
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prediction of residual retroperitoneal mass histology after chemotherapy for metastatic nonseminomatous germ cell tumor multivariate analysis of individual patient data from six study groups
Journal of Clinical Oncology, 1995Co-Authors: Ewout W Steyerberg, H J Keizer, Sophie D Fossa, D T Sleijfer, Guy C Toner, Schraffordt H Koops, P F Mulders, Jonathan E Messemer, John P DonohueAbstract:PURPOSE: To develop a statistical model that predicts the histology (necrosis, Mature Teratoma, or cancer) after chemotherapy for metastatic nonseminomatous germ cell tumor (NSGCT). PATIENTS AND METHODS: An international data set was collected comprising individual patient data from six study groups. Logistic regression analysis was used to estimate the probability of necrosis and the ratio of cancer and Mature Teratoma. RESULTS: Of 556 patients, 250 (45%) had necrosis at resection, 236 (42%) had Mature Teratoma, and 70 (13%) had cancer. Predictors of necrosis were the absence of Teratoma elements in the primary tumor, prechemotherapy normal alfa-fetoprotein (AFP), normal human chorionic gonadotropin (HCG), and elevated lactate dehydrogenase (LDH) levels, a small prechemotherapy or postchemotherapy mass, and a large shrinkage of the mass during chemotherapy. Multivariate combination of predictors yielded reliable models (goodness-of-fit tests, P > .20), which discriminated necrosis well from other histologies (area under the receiver operating characteristic (ROC) curve, .84), but which discriminated cancer only reasonably from Mature Teratoma (area, .66). Internal and external validation confirmed these findings. CONCLUSION: The validated models estimate with high accuracy the histology at resection, especially necrosis, based on well-known and readily available predictors. The predicted probabilities may help to choose between immediate resection of a residual mass or follow-up, taking into account the expected benefits and risks of resection, feasibility of frequent follow-up, the financial costs, and the patient's individual preferences.
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prediction of residual retroperitoneal mass histology after chemotherapy for metastatic nonseminomatous germ cell tumor multivariate analysis of individual patient data from six study groups
Journal of Clinical Oncology, 1995Co-Authors: Ewout W Steyerberg, H J Keizer, Sophie D Fossa, D T Sleijfer, Guy C Toner, Schraffordt H Koops, P F Mulders, Jonathan E Messemer, K Ney, John P DonohueAbstract:PURPOSETo develop a statistical model that predicts the histology (necrosis, Mature Teratoma, or cancer) after chemotherapy for metastatic nonseminomatous germ cell tumor (NSGCT).PATIENTS AND METHODSAn international data set was collected comprising individual patient data from six study groups. Logistic regression analysis was used to estimate the probability of necrosis and the ratio of cancer and Mature Teratoma.RESULTSOf 556 patients, 250 (45%) had necrosis at resection, 236 (42%) had Mature Teratoma, and 70 (13%) had cancer. Predictors of necrosis were the absence of Teratoma elements in the primary tumor, prechemotherapy normal alfa-fetoprotein (AFP), normal human chorionic gonadotropin (HCG), and elevated lactate dehydrogenase (LDH) levels, a small prechemotherapy or postchemotherapy mass, and a large shrinkage of the mass during chemotherapy. Multivariate combination of predictors yielded reliable models (goodness-of-fit tests, P > .20), which discriminated necrosis well from other histologies (ar...