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What is it about?
This study aimed to validate Vergouwe's prediction model for benign histopathology in post-chemotherapy retroperitoneal lymph node dissection (PC-RPLND) using the Swedish and Norwegian Testicular Cancer Group (SWENOTECA) RETROP database and to define its clinical utility. The study found that the model showed good reproducibility and discrimination, with an area under the receiver-operating characteristic curve (AUC) of 0.82. A decision threshold of 70% for benign histopathology was selected, and using this threshold, 61 patients would have been spared surgery. However, only 51 of these 61 patients were correctly classified as benign. The model may identify patients with a high chance of benign histopathology, thus sparing patients of surgery, but meticulous follow-up is required.
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Why is it important?
This research is important because it validates and updates a prediction model for post-chemotherapy retroperitoneal lymph node dissection (PC-RPLND) surgery. The model helps predict the likelihood of benign histopathology, sparing patients from unnecessary surgery and its associated risks. The model's validation and clinical utility analysis contribute to a better understanding of its potential impact on patient care, especially in the context of metastatic nonseminoma testicular cancer. Key Takeaways: 1. Vergouwe's prediction model for benign histopathology in PC-RPLND uses variables such as teratoma presence, alphafetoprotein levels, and lymph node size. 2. The study validated the model using the Swedish and Norwegian Testicular Cancer Group (SWENOTECA) RETROP database, finding good reproducibility and discrimination. 3. A decision threshold of 70% for benign histopathology identification was selected, resulting in an NB opt-out of 0.098, and 61 patients would have been spared surgery. 4. The model's clinical utility was established using decision curve analysis, which showed that the model may help identify patients with a high chance of benign histopathology, reducing the number of unnecessary surgeries. 5. The study highlights the importance of meticulous follow-up in patients undergoing PC-RPLND, as not all patients with benign histopathology will be correctly classified by the model.
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This page is a summary of: Validation of a prediction model for post‐chemotherapy fibrosis in nonseminoma patients, BJU International, May 2023, Wiley,
DOI: 10.1111/bju.16040.
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