Evidence map›Paper›PMID 40498596›Full record

ArticleJournal of adolescent and young adult oncology2026

Association of Guideline-Concordant Care with Survival in Adolescent and Young Adult Patients with Germ Cell Tumors.

Elysia Alvarez, Marcio Malogolowkin, A Lindsay Frazier, Qian Li, Ann Brunson, Fran Maguire, Renata Abrahao, Mamta Parikh, Hui Chen, Theresa H M Keegan

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of adolescent and young adult oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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.

Elysia AlvarezDivision of Pediatric Hematology and Oncology, Department of Pediatrics, University of California Davis School of Medicine, Sacramento, California, USA.ORCID 0000-0002-1615-2848
Marcio MalogolowkinDivision of Pediatric Hematology and Oncology, Department of Pediatrics, University of California Davis School of Medicine, Sacramento, California, USA.
A Lindsay FrazierDana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts, USA.
Qian LiDivision of Hematology and Oncology, University of California Davis School of Medicine, Sacramento California,USA.
Ann BrunsonDivision of Hematology and Oncology, University of California Davis School of Medicine, Sacramento California,USA.
Fran MaguireCalifornia Cancer Reporting and Epidemiologic Surveillance Program, University of California Davis Comprehensive Cancer Center, University of California Davis Health, Sacramento, California, USA.
Renata AbrahaoDivision of Hematology and Oncology, University of California Davis School of Medicine, Sacramento California,USA.
Mamta ParikhDivision of Hematology and Oncology, Department of Internal Medicine, University of California Davis School of Medicine, Sacramento, California, USA.
Hui ChenDivision of Gynecology Oncology, Davis Comprehensive Cancer Center, University of California, Sacramento, California, USA.
Theresa H M KeeganDivision of Hematology and Oncology, University of California Davis School of Medicine, Sacramento California,USA.

Funding

Institutional Career Development Core (KL2)KL2TR001859 · NCATS · UNIVERSITY OF CALIFORNIA AT DAVIS · PI HOLMES, JAMES F. · 2016 to 2025
$10.1M
Building Interdisciplinary Research Careers in Womens Health at UC Davis - Administrative SupplementK12HD051958 · NICHD · UNIVERSITY OF CALIFORNIA DAVIS · PI LANE, NANCY E · 2005 to 2023
$9.6M
NCATS NIH HHS KL2 TR001859NICHD NIH HHS K12 HD051958NIH HHS 5K12HD051958
6 · The paper itself

Abstract

purposeTreatment for germ cell tumors (GCTs) in adolescent and young adults (AYA: 15-39) spans different primary sites and multiple specialties. Little is known about the treatment patterns outside of clinical trials, including the delivery of guideline-concordant care.

methodsThis is a population-based, retrospective cohort study of AYAs diagnosed (2004-2018) with GCT. Guideline-concordant care was determined using treatment text-field data from the California Cancer Registry. Survival models measured the impact of guideline-concordant care as a time-dependent variable on overall survival accounting for known prognostic factors. GCTs were analyzed separately by primary site (extragonadal, ovarian, and testicular).

resultsThe majority of patients had testicular GCT (90.4%), early-stage disease (stage I/II: 75.3%), and received part/no treatment at a specialized cancer center (SCC) (77.5%). For treatment, 37.6% of patients received surgery plus chemotherapy, followed by surgery alone (36.2%). The most common chemotherapy regimen was bleomycin, etoposide, and cisplatin. Sixty-four percent of patients received guideline-concordant care, with variations by primary site (extragonadal 54.7%, ovarian 70.1%, and testicular 64.6%). Receipt of guideline-concordant care was associated with superior survival for testicular primaries (hazard ratio = 0.56, confidence interval: 0.45-0.69). Patients with testicular primaries who had no treatment at an SCC were less likely to receive guideline-concordant care.

conclusionThis study identified that receipt of guideline-concordant care was associated with improved survival; however, a substantial proportion of AYA patients do not receive this care, highlighting the need to investigate the barriers to the delivery of guideline-concordant care in this patient population.

Indexed as

Guideline AdherenceNeoplasms, Germ Cell and EmbryonalAdolescentAdultFemaleHumansMalePractice Guidelines as TopicPrognosisRetrospective StudiesSurvival RateYoung AdultAYAsGCTguideline-concordant carepatterns of care

Identifiers

PMID40498596
PMCPMC13535571

What OpenQuestion holds

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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.