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dc.contributor.authorGerdtsson, Axel
dc.contributor.authorTorisson, Gustav
dc.contributor.authorThor, Anna
dc.contributor.authorGrenabo Bergdahl, Anna
dc.contributor.authorAlmås, Bjarte
dc.contributor.authorHåkansson, Ulf
dc.contributor.authorTörnblom, Magnus
dc.contributor.authorNegaard, Helene Francisca Stigter
dc.contributor.authorGlimelius, Ingrid
dc.contributor.authorHalvorsen, Dag
dc.contributor.authorKarlsdottir, Åsa
dc.contributor.authorHaugnes, Hege Sagstuen
dc.contributor.authorLarsen, Signe Melsen
dc.contributor.authorHolmberg, Göran
dc.contributor.authorWahlqvist, Rolf
dc.contributor.authorTandstad, Torgrim
dc.contributor.authorCohn-Cedermark, Gabriella
dc.contributor.authorStåhl, Olof
dc.contributor.authorKjellman, Anders
dc.date.accessioned2023-08-25T10:51:40Z
dc.date.available2023-08-25T10:51:40Z
dc.date.issued2023-05-02
dc.description.abstractObjective - To validate Vergouwe's prediction model using the Swedish and Norwegian Testicular Cancer Group (SWENOTECA) RETROP database and to define its clinical utility.<p> <p>Materials and methods - Vergouwe's prediction model for benign histopathology in post-chemotherapy retroperitoneal lymph node dissection (PC-RPLND) uses the following variables: presence of teratoma in orchiectomy specimen; pre-chemotherapy level of alpha-fetoprotein; β-Human chorionic gonadotropin and lactate dehydrogenase; and lymph node size pre- and post-chemotherapy. Our validation cohort consisted of patients included in RETROP, a prospective population-based database of patients in Sweden and Norway with metastatic nonseminoma, who underwent PC-RPLND in the period 2007–2014. Discrimination and calibration analyses were used to validate Vergouwe's prediction model results. Calibration plots were created and a Hosmer–Lemeshow test was calculated. Clinical utility, expressed as opt-out net benefit (NBopt-out), was analysed using decision curve analysis.<p> <p>Results - Overall, 284 patients were included in the analysis, of whom 130 (46%) had benign histology after PC-RPLND. Discrimination analysis showed good reproducibility, with an area under the receiver-operating characteristic curve (AUC) of 0.82 (95% confidence interval 0.77–0.87) compared to Vergouwe's prediction model (AUC between 0.77 and 0.84). Calibration was acceptable with no recalibration. Using a prediction threshold of 70% for benign histopathology, NBopt-out was 0.098. Using the model and this threshold, 61 patients would have been spared surgery. However, only 51 of 61 were correctly classified as benign.<p> <p>Conclusions - The model was externally validated with good reproducibility. In a clinical setting, the model may identify patients with a high chance of benign histopathology, thereby sparing patients of surgery. However, meticulous follow-up is required.en_US
dc.identifier.citationGerdtsson, Torisson, Thor, Grenabo Bergdahl, Almås, Håkansson, Törnblom, Negaard, Glimelius, Halvorsen, Karlsdottir, Haugnes, Larsen, Holmberg, Wahlqvist, Tandstad, Cohn-Cedermark, Ståhl, Kjellman. Validation of a prediction model for post-chemotherapy fibrosis in nonseminoma patients. BJU International. 2023en_US
dc.identifier.cristinIDFRIDAID 2151068
dc.identifier.doi10.1111/bju.16040
dc.identifier.issn1464-4096
dc.identifier.issn1464-410X
dc.identifier.urihttps://hdl.handle.net/10037/30424
dc.language.isoengen_US
dc.publisherWileyen_US
dc.relation.journalBJU International
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2023 The Author(s)en_US
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0en_US
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)en_US
dc.titleValidation of a prediction model for post-chemotherapy fibrosis in nonseminoma patientsen_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)
Except where otherwise noted, this item's license is described as Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)