Cox univariate and multivariate analysis of failure free survival according to RBM3 expression in patients with metastatic non-seminomatous testicular cancer.

<p>* Multivariable analysis on tumor marker status and non-pulmonary visceral metastasis.</p><p>Tumor markers (AFP, HCG, LDH) as continuous variables.</p><p>Cox univariate and multivariate analysis of failure free survival according to RBM3 expression in patients with metastatic non-seminomatous testicular cancer.</p

Association between clinicopathological characteristics in 206 patients with non-seminomatous testicular cancer and RBM3 expression.

<p>^↑Nuclear score < = 0.5</p><p>^↓Nuclear score > 0.5</p><p>^‡ According to ICCCGC</p><p>*Patients with CS>1</p><p>Abbreviations: AFP, α-fetoprotein; β-HCG, β–human chorionic gonadotropin; LDH, lactate dehydrogenase; NPVM, non-pulmonary visceral metastasis.</p><p>Association between clinicopathological characteristics in 206 patients with non-seminomatous testicular cancer and RBM3 expression.</p

RBM3 staining distribution in non-seminomatous germ cell tumour (NSGCT) denoted as nuclear score (fraction × intensity).

<p>(A) mean score, (B) highest score and (C) lowest score. RBM3 staining distribution according to CS I and CS > 1 on (D) mean score, (E) highest score and (F) lowest score. Boxplots shows the five statistics (minimum, first quartile, median, third quartile, and maximum). P-values refer to Mann Whitney U test for comparison of medians.</p

Cox univariate and multivariate analysis of failure free survival according to RBM3 expression in patients with metastatic non-seminomatous testicular cancer.

<p>* Multivariable analysis on tumor marker status and non-pulmonary visceral metastasis.</p><p>Tumor markers (AFP, HCG, LDH) as categorical variables. The cut points defined in the IGCCC are used.</p><p>Cox univariate and multivariate analysis of failure free survival according to RBM3 expression in patients with metastatic non-seminomatous testicular cancer.</p

Failure-free survival of patients with non-seminomatous testicular cancer according to RBM3 expression.

<p>(A) 118 patients with clinical stage 1, (B) 88 patients with metastatic disease and (C) 206 patients with clinical stage I to IV and Mk+.</p

Sample images (10X magnification) of immunohistochemical RBM3 expression in different tissue entities from four cases.

<p>Case 1—column 1: atrophic testis; column 2–4: embryonal carcinoma with negative RBM3 expression (note positive stromal lymphocytes). Case 2—column 1: intratubular germ cell neoplasia (ITGCN); column 2–4: embryonal carcinoma with <10% seminoma (column 2) with best score 12 and worst score 2. Case 3—column 1 normal testis; column 2–4: tumour with components of embryonal carcinoma, immature teratoma and yolk sac tumour with best score 12 and worst score 8. Case 4—column 1 normal testis; column 2–4: tumour with predominant seminomatous histology (~80%) admixed with teratoma (not represented in the TMA), best score 12 and worst score 8.</p

Sick leave and disability pension among Swedish testicular cancer survivors according to clinical stage and treatment

<div><p><b>Purpose.</b> To investigate if testicular cancer survivors (TCSs) have a higher incidence of work loss compared with the population, accounting for stage, treatment and relapse.</p><p><b>Material and methods.</b> A cohort of 2146 Swedish TCSs diagnosed 1995–2007 (seminoma n = 926, non-seminoma n = 1220) was identified in the SWENOTECA (Swedish-Norwegian Testicular Cancer Group) register, and matched 1:4 to population comparators. Prospectively recorded work loss data (both before and after diagnosis) were obtained from national registers through September 2013. Adjusted relative risks (RR) and 95% confidence intervals (CI) of sick leave and/or disability pension were calculated annually and overall with Poisson- and Cox regression, censoring at relapse. The mean number of annual work days lost was also estimated.</p><p><b>Results.</b> TCSs were at a modestly increased annual risk of work loss up to the third year of follow-up (RR_{3rd year} 1.25, 95% CI 1.08, 1.43), attributed to a more pronounced risk among extensively treated patients (4 chemotherapy courses: RR_{3rd year} 1.60, 95% CI 1.19, 2.15; > 4 courses: RR_{3rd year} 3.70, 95% CI 2.25, 6.11). Patients on surveillance or limited treatment (radiotherapy, 1–3 chemotherapy courses) did not have an increased risk of work loss beyond the first year. TCSs receiving > 4 chemotherapy courses had higher mean number of annual days of work loss up to the 10th year post-diagnosis, and a five-fold risk of disability pension (RR 5.16, 95% CI 2.00, 10.3).</p><p><b>Conclusion.</b> Extensively treated TCSs, but not those on surveillance or limited treatment, are at increased risk of work loss long-term, not explained by relapse. These patients may benefit from early rehabilitation initiatives.</p></div