Evidence map›Paper›PMID 36059636›Full record

SynthesisFrontiers in oncology2022

A meta-analysis of clinicopathologic features that predict necrosis or fibrosis at post-chemotherapy retroperitoneal lymph node dissection in individuals receiving treatment for non-seminoma germ cell tumours.

Ciara Conduit, Wei Hong, Felicity Martin, Benjamin Thomas, Nathan Lawrentschuk, Jeremy Goad, Peter Grimison, Nariman Ahmadi, Ben Tran, Jeremy Lewin

Abstract readSystematic Review
In one paragraph

Synthesis in Frontiers in oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Nuclear medicine imaging in non-seminomatous germ cell tumors: lessons learned from the past failures.Cancer imaging : the official publication of the International Cancer Imaging Society · 2024
    Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Ciara ConduitDepartment of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
Wei HongPersonalised Oncology, Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia.
Felicity MartinDepartment of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
Benjamin ThomasDepartment of Surgery, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia.
Nathan LawrentschukDepartment of Surgery, Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia.
Jeremy GoadDepartment of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
Peter GrimisonDepartment of Medical Oncology, Chris O'Brien Lifehouse, Camperdown, NSW, Australia.
Nariman AhmadiDepartment of Urology, Chris O'Brien Lifehouse, Camperdown, NSW, Australia.
Ben TranDepartment of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
Jeremy LewinDepartment of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose: Post-chemotherapy retroperitoneal lymph node dissection (pcRPLND) for residual nodal masses is a critical component of care in metastatic testicular germ cell tumour (GCT). However, the procedure is not of therapeutic value in up to 50% of individuals in whom histopathology demonstrates post-treatment necrosis or fibrosis alone. Improved diagnostic tools and clinicopathologic features are needed to separate individuals who benefit from pcRPLND and avoid surgery in those who do not. Methods: A prospectively registered meta-analysis of studies reporting clinicopathologic features associated with teratoma, GCT and/or necrosis/fibrosis at pcRPLND for metastatic non-seminoma GCT (NSGCT) was undertaken. We examined the effect of various clinicopathologic factors on the finding of necrosis/fibrosis at pcRPLND. The log odds ratios (ORs) of each association were pooled using random-effects models. Results: Using the initial search strategy, 4,178 potentially eligible abstracts were identified. We included studies providing OR relating to clinicopathologic factors predicting pcRPLND histopathology, or where individual patient-level data were available to permit the calculation of OR. A total of 31 studies evaluating pcRPLND histopathology in 3,390 patients were eligible for inclusion, including two identified through hand-searching the reference lists of eligible studies. The following were associated with the presence of necrosis/fibrosis at pcRPLND: absence of teratomatous elements in orchidectomy (OR 3.45, 95% confidence interval [CI] 2.94-4.17); presence of seminomatous elements at orchidectomy (OR 2.71, 95% CI 1.37-5.37); normal pre-chemotherapy serum bHCG (OR 1.96, 95% CI 1.62-2.36); normal AFP (OR 3.22, 95% CI 2.49-4.15); elevated LDH (OR 1.72, 95% CI 1.37-2.17); >50% change in mass during chemotherapy (OR 4.84, 95% CI 3.94-5.94); and smaller residual mass size (<2 cm Conclusions: In this meta-analysis, clinicopathologic features helped predict the presence of pcRPLND necrosis/fibrosis. Collaboration between centres that provide individual patient-level data is required to develop and validate clinical models and inform routine care to direct pcRPLND to individuals most likely to derive benefits. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42021279699.

Indexed as

germinomameta-analysispathologyteratomatesticular neoplasms

Identifiers

PMID36059636
PMCPMC9428700

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.