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Validation of a pre...
Validation of a prediction model for post-chemotherapy fibrosis in nonseminoma patients
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- Gerdtsson, Axel (författare)
- Karolinska Institute,Skåne University Hospital
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- Torisson, Gustav (författare)
- Lund University,Lunds universitet,Klinisk infektionsmedicin,Forskargrupper vid Lunds universitet,Kognitiv sjukdomsforskning,Institutionen för kliniska vetenskaper, Malmö,Medicinska fakulteten,Clinical infection medicine,Lund University Research Groups,Cognitive disorders,Department of Clinical Sciences, Malmö,Faculty of Medicine
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- Thor, A. (författare)
- Karolinska Institute,Karolinska Institutet,Karolinska University Hospital
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- Grenabo Bergdahl, Anna (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för urologi,Institute of Clinical Sciences, Department of Urology,Sahlgrenska Academy,Sahlgrenska University Hospital
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- Almas, B. (författare)
- Haukeland University Hospital
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- Håkansson, Ulf (författare)
- CAPIO närsjukvård AB
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- Tornblom, M. (författare)
- Karolinska Institute,Visby hospital
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- Negaard, H. F. S. (författare)
- Oslo university hospital,UiT The Arctic University of Norway, Tromsø,University Hospital of North Norway
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- Glimelius, I. (författare)
- Uppsala University
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- Halvorsen, D. (författare)
- St. Olav’s University Hospital
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- Karlsdottir, A. (författare)
- Haukeland University Hospital
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Haugnes, H. S. (författare)
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- Larsen, S. M. (författare)
- Oslo university hospital
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- Holmberg, G. (författare)
- Sahlgrenska University Hospital
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- Wahlqvist, R. (författare)
- Oslo university hospital
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- Tandstad, T. (författare)
- St. Olav’s University Hospital,Norwegian University of Science and Technology
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- Cohn-Cedermark, G. (författare)
- Karolinska Institute,Karolinska Institutet,Karolinska University Hospital
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- Ståhl, Olof (författare)
- Lund University,Lunds universitet,Medicinsk onkologi,Sektion I,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Medical oncology,Section I,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital
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- Kjellman, A. (författare)
- Karolinska Institute,Karolinska Institutet,Karolinska University Hospital
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(creator_code:org_t)
- 2023
- 2023
- Engelska.
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Ingår i: Bju International. - 1464-4096 .- 1464-410X. ; 132:3, s. 329-336
- Relaterad länk:
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http://dx.doi.org/10... (free)
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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http://kipublication...
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https://lup.lub.lu.s...
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Abstract
Ämnesord
Stäng
- Objective To validate Vergouwe's prediction model using the Swedish and Norwegian Testicular Cancer Group (SWENOTECA) RETROP database and to define its clinical utility. Materials and methods Vergouwe's prediction model for benign histopathology in post-chemotherapy retroperitoneal lymph node dissection (PCRPLND) uses the following variables: presence of teratoma in orchiectomy specimen; pre-chemotherapy level of alphafetoprotein; b-Human chorionic gonadotropin and lactate dehydrogenase; and lymph node size pre- and postchemotherapy. Our validation cohort consisted of patients included in RETROP, a prospective population-based database of patients in Sweden and Norway with metastatic nonseminoma, who underwent PC-RPLND in the period 2007-2014. Discrimination and calibration analyses were used to validate Vergouwe's prediction model results. Calibration plots were created and a Hosmer-Lemeshow test was calculated. Clinical utility, expressed as opt-out net benefit (NBopt-out), was analysed using decision curve analysis. Results Overall, 284 patients were included in the analysis, of whom 130 (46%) had benign histology after PC-RPLND. Discrimination analysis showed good reproducibility, with an area under the receiver-operating characteristic curve (AUC) of 0.82 (95% confidence interval 0.77-0.87) compared to Vergouwe's prediction model (AUC between 0.77 and 0.84). Calibration was acceptable with no recalibration. Using a prediction threshold of 70% for benign histopathology, NBopt-out was 0.098. Using the model and this threshold, 61 patients would have been spared surgery. However, only 51 of 61 were correctly classified as benign. Conclusions The model was externally validated with good reproducibility. In a clinical setting, the model may identify patients with a high chance of benign histopathology, thereby sparing patients of surgery. However, meticulous follow-up is required.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Urology and Nephrology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Nyckelord
- clinical decision rules
- lymph node excision
- forecasting
- neoplasms
- germ cell and embryonal
- nonseminomatous germ cell tumour
- testicular
- neoplasms
- germ-cell tumors
- retroperitoneal mass histology
- lymph-node dissection
- testicular cancer
- follow-up
- chemotherapy
- lymphadenectomy
- validity
- benign
- Urology & Nephrology
- testicular neoplasms
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
Hitta via bibliotek
Till lärosätets databas
- Av författaren/redakt...
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Gerdtsson, Axel
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Torisson, Gustav
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Thor, A.
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Grenabo Bergdahl ...
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Almas, B.
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Håkansson, Ulf
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visa fler...
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Tornblom, M.
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Negaard, H. F. S ...
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Glimelius, I.
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Halvorsen, D.
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Karlsdottir, A.
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Haugnes, H. S.
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Larsen, S. M.
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Holmberg, G.
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Wahlqvist, R.
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Tandstad, T.
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Cohn-Cedermark, ...
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Ståhl, Olof
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Kjellman, A.
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visa färre...
- Om ämnet
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Urologi och njur ...
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Kirurgi
- Artiklar i publikationen
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Bju Internationa ...
- Av lärosätet
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Göteborgs universitet
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Karolinska Institutet
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Lunds universitet