| TNM, stage, IGCCCG | Similar or Different | RPLND NSGCT |
|---|---|---|
|
What is pT2.
(F/U: what's the stage)
A tumour of the testis/epididymis + LVI or tunica vaginalis involvement.
|
Which subtypes produce HCG, and have syncitiotrophoblasts.
Seminoma, embryonal, and choriocarcinoma.
|
What is the rate of teratoma in RP nodes.
15-25% of CS1, and up to 30% of CS2.
|
|
What is the difference between pN2 and cN2.
In addition, >5 RP nodes or extranodal extension.
|
What is the receptor's alpha subunit.
TSH, LH, and HCG share this.
|
What is a study comparing primary RPLND w/ adj chemo (BEPx2) for pS2 vs primary chemo (BEPx1).
Albers et al (2008) showed a 2-yr PFS of 99% vs 92%.
|
|
What is S3 (choreo storm).
LDH 3x ULN, AFP 2, HCG 52,000.
|
What is the route of spread of GCT's except for choriocarcinoma (hematogenous).
Spread via lymphatic channels.
|
What is arguments in favour of RPLND for CS2a-b disease.
13-35% of patients are pN0, up to 50% avoid chemo, and ejaculatory function is preserved in 70-90% of patients.
|
|
What is the IGCCCG 5-yr PFS and OS of intermediate and poor risk NSGCT, and intermediate seminoma.
75% and 80%; 41% and 48%; 67% and 72%.
|
What is the primary risk factors for occult metastasis of Seminoma and NSGCT.
(F/U: what's the NSGCT risk w/out EC and LVI?
Rete testis involvement/>4cm vs. Embryonal/LVI.
|
What is predictors of systemic relapse after RPLND.
Elevated post-orch AFP/HCG, or bulky RP nodes (>3cm).
|
|
What is the IGCCCG poor risk NSGCT vs. intermediate risk seminoma.
Mediastinal primary/non-pulmonary visceral mets/S3 vs. Non-pulmonary visceral mets and any HCG/LHD.
|
What is the genetic difference between spermatocytic tumours and NSGCT/seminoma/malig tranformation of teratoma.
Extra copies of genetic material from 12p (GCT subtypes) may differentiate these.
|
What is the likelihood of necrosis-only in a post-chemo residual mass.
Residual mass size, % shrinkage of a residual mass to first-line chemo, and a lack of teratoma in the primary specimen (testicle) are predictors of this.
|
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