AI Article Synopsis

  • - The SWENOTECA-MIR study evaluates the effectiveness of miR-371a-3p as a new marker for detecting viable tumors in metastatic germ cell tumor patients undergoing retroperitoneal lymph node dissection (RPLND).
  • - In the study of 114 patients, miR-371a-3p showed mixed results, with better performance in seminoma patients than in nonseminomas, particularly before chemotherapy.
  • - Overall, while miR-371a-3p demonstrated high specificity in certain groups, its overall sensitivity, especially post-chemotherapy, was low, highlighting potential limitations in using it as a reliable marker for viable tumor detection.

Article Abstract

Purpose: The SWENOTECA-MIR prospective multicenter study aims to assess the clinical value of miR-371a-3p as a novel marker in metastatic germ cell tumor patients undergoing retroperitoneal lymph node dissection (RPLND), to predict the presence of viable residual tumor.

Materials And Methods: A total of 114 patients (86 nonseminomas, 28 seminomas) who underwent surgery for presumed metastatic disease pre chemotherapy (primary RPLND) and post chemotherapy RPLND were included. The expression of miR-371a-3p was evaluated using reverse transcription-digital droplet polymerase chain reaction before and after RPLND. Pre- and postoperative miR-371a-3p levels were statistically compared, and optimism-corrected performance calculations compared with conventional serum tumor markers. Associations were evaluated by logistic regression. Patients who underwent primary RPLND were categorized into seminoma and nonseminoma groups.

Results: Among the seminoma patients (n = 24) undergoing primary RPLND, all had normal conventional markers. Six patients received adjuvant treatment before surgery. miR-371a-3p exhibited a sensitivity of 74%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 21% for viable tumor. The levels of miR-371a-3p significantly decreased after surgery. In the nonseminoma group (n = 18) treated with primary RPLND, 22% had elevated conventional markers and 3 had received prior adjuvant treatment. miR-371a-3p showed a sensitivity of 34%, specificity of 88%, positive predictive value of 67%, and negative predictive value of 62% for the primary nonseminoma patients. No association was observed between stage or prior adjuvant treatment and the outcome of the miR test. In the postchemotherapy group (n = 72), the miR-371a-3p sensitivity was 9%, reducing to 0 when excluding patients with seminoma (n = 4). Teratomas and benign histology were essentially negative.

Conclusions: Our study highlights miR-371a-3p as a fairly sensitive and highly specific marker for prechemotherapy seminomas, outperforming conventional markers. However, in prechemotherapy nonseminomas as well as in postchemotherapy patients, we observed low sensitivity and no significant differences in miR-371a-3p levels before and after surgery, suggesting limited utility for miR-371a-3p in this context.

Download full-text PDF

Source
http://dx.doi.org/10.1097/JU.0000000000004164DOI Listing

Publication Analysis

Top Keywords

primary rplnd
16
patients undergoing
12
conventional markers
12
adjuvant treatment
12
mir-371a-3p
11
patients
9
viable tumor
8
tumor patients
8
undergoing retroperitoneal
8
retroperitoneal lymph
8

Similar Publications

Purpose Of Review: Chemotherapy offers excellent long-term survival rates for men with clinical stage II germ cell tumours. However, in this predominantly younger population, chemotherapy is associated with long-term adverse effects. Primary retroperitoneal lymph node dissection (RPLND) may serve as an alternative treatment option, preserving oncological safety while potentially reducing adverse effects in men with limited retroperitoneal disease.

View Article and Find Full Text PDF

Contemporary surgical management of testicular seminoma.

Transl Cancer Res

November 2024

Division of Urologic Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.

Testicular cancer is the most commonly diagnosed cancer among young men in the United States. Seminoma comprises a little over half of all testicular germ cell neoplasms. After radial inguinal orchiectomy, management of seminoma is dictated by tumor stage and risk stratification.

View Article and Find Full Text PDF

Objectives: To reassess the role of primary retroperitoneal lymph node dissection (RPLND) in patients with marker-negative non-seminomatous germ cell tumour (NSGCT) clinical stage (CS) 2a, to explore results in patients with CS 2b and to evaluate surgical methods, recurrence, and adjuvant chemotherapy indications.

Materials And Methods: Data from 17 institutions were collected, comprising 305 men who underwent primary RPLND for CS 2 NSGCT. Regression analyses were conducted to predict histology in the RPLND specimen and disease-free survival (DFS).

View Article and Find Full Text PDF

Background And Objective: Studies in metastatic nonseminomatous germ-cell tumor (NSGCT) suggest that the presence of teratomatous elements in the primary tumor is a risk factor for poor survival. Many guidelines have extrapolated this observation and recommend adjuvant retroperitoneal lymph-node dissection (RPLND) even for clinical stage I (CSI) teratoma confined to the testicle. Our objective was to assess relapse-free survival (RFS), cancer-specific survival (CSS), overall survival (OS) among patients with CSI pure teratoma in comparison to CSI NSGCT.

View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to systematically review the role of primary retroperitoneal lymph node dissection (RPLND) in stage II testicular seminoma, analyzing its oncological, functional, and peri-operative outcomes based on existing literature up to November 2023.
  • Six studies encompassing 385 patients were reviewed, revealing a median operation time of 187 minutes, a median blood loss of 150 mL, and a typical hospital stay of 4 days, with a complication rate of 6.1% for serious issues.
  • While long-term survival data is limited, one study showed a 92% 5-year overall survival for treated stage IIA/B disease, indicating that R
View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!