Patient selection: male with retroperitoneal metastases from a nonseminomatous germ cell tumor with normal levels of tumor markers AFP and HCG after chemotherapy and before resection
NOTE: A corresponding point score is given in Table 8, page 1184.
Parameters:
(1) presence of teratomatous elements in primary tumor
(2) serum AFP before chemotherapy
(3) serum HCG before chemotherapy
(4) ratio of serum LDH to upper limit of normal (ULN) before chemotherapy
(5) maximum diameter after chemotherapy in mm
(6) shrinkage of tumor in CT scan after chemotherapy as a percent
shrinkage after chemotherapy =
= ((diameter before) - (diameter after)) / (diameter before) * 100%
|
Parameter
|
Finding
|
Points
|
|
teratomatous elements
|
absent
|
1
|
|
|
present
|
0
|
|
serum AFP
|
normal
|
1
|
|
|
elevated
|
0
|
|
serum HCG
|
normal
|
1
|
|
|
elevated
|
0
|
sumscore =
= (8.58 * (points for teratomatous elements)) + (8.7 * (points for serum AFP)) + 7.61 * (points for serum HCG)) + (9.69 * LN(ratio LDH to ULN)) - (2.83 * SQRT(diameter in mm after chemotherapy)) + (0.147 * (percent shrinkage)) - 9.78
X =
= (sumscore) / 10
probability of necrosis in the residual retroperitoneal masses =
= 1 / (1 + EXP((-1) * X))
