Development of a predictive model utilising lesion size as a cutoff to predict testicular cancer in patients with small testicular masses
BAUS ePoster online library. Wardak S. 06/21/21; 319081; p4-3
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Mr. Shafiullah Wardak
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Abstract
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Introduction:
In this study we evaluated predictive markers for testicular cancer (TC) in patients with indeterminate small testicular masses (STM) often found on routine ultrasound.
Patients & Methods:
We retrospectively analysed the records of patients who underwent testicular biopsy or orchidectomy for STMs. All patients with testicular lesions smaller than 2 cm on ultrasound were included in the study. ROC curve was used to evaluate the area under the curve (AUC) using tumour dimension (TD) as a single marker to predict TC. We searched for the TD cutoff value with the highest combined sensitivity and specificity predicting TC. Univariate and multivariate logistic regression analysis were performed. Internal validation (bootstrap; N=1000 samples)) was performed.
Results:
A total of 144 patients were included. No patient had elevated pre-operative tumour markers. Overall, 74 of the 144 men (51.4%) were diagnosed with TC. On ROC analysis, the lesion diameter had an AUC of 0.76 (95% CI 0.67-0.84, p=0.01) to predict TC. At the best cutoff of 10 mm the diameter of the lesion had 64% sensitivity, 78% specificity (Figure1). The Multivariate-analysis, including age, clinical presentation, TD cutoff, and the number of lesions, showed that the age (OR 0.45;95%;CI:0.007–0.13;p=0.048), the TD-cutoff (OR 1.84;95%CI:0.504–3.83;p=0.01) and presence of vascularisation within the lesion on ultrasound imaging (OR:2.73;95%;CI0.857–17.53;p=0.01) were predictors of malignancy.
Conclusions:
Our study confirms that the majority of STMs are benign. TD is an independent predictor of TC. Patients with a TD exceeding the cutoff of 10 mm are more likely to be diagnosed with TC.
In this study we evaluated predictive markers for testicular cancer (TC) in patients with indeterminate small testicular masses (STM) often found on routine ultrasound.
Patients & Methods:
We retrospectively analysed the records of patients who underwent testicular biopsy or orchidectomy for STMs. All patients with testicular lesions smaller than 2 cm on ultrasound were included in the study. ROC curve was used to evaluate the area under the curve (AUC) using tumour dimension (TD) as a single marker to predict TC. We searched for the TD cutoff value with the highest combined sensitivity and specificity predicting TC. Univariate and multivariate logistic regression analysis were performed. Internal validation (bootstrap; N=1000 samples)) was performed.
Results:
A total of 144 patients were included. No patient had elevated pre-operative tumour markers. Overall, 74 of the 144 men (51.4%) were diagnosed with TC. On ROC analysis, the lesion diameter had an AUC of 0.76 (95% CI 0.67-0.84, p=0.01) to predict TC. At the best cutoff of 10 mm the diameter of the lesion had 64% sensitivity, 78% specificity (Figure1). The Multivariate-analysis, including age, clinical presentation, TD cutoff, and the number of lesions, showed that the age (OR 0.45;95%;CI:0.007–0.13;p=0.048), the TD-cutoff (OR 1.84;95%CI:0.504–3.83;p=0.01) and presence of vascularisation within the lesion on ultrasound imaging (OR:2.73;95%;CI0.857–17.53;p=0.01) were predictors of malignancy.
Conclusions:
Our study confirms that the majority of STMs are benign. TD is an independent predictor of TC. Patients with a TD exceeding the cutoff of 10 mm are more likely to be diagnosed with TC.
Introduction:
In this study we evaluated predictive markers for testicular cancer (TC) in patients with indeterminate small testicular masses (STM) often found on routine ultrasound.
Patients & Methods:
We retrospectively analysed the records of patients who underwent testicular biopsy or orchidectomy for STMs. All patients with testicular lesions smaller than 2 cm on ultrasound were included in the study. ROC curve was used to evaluate the area under the curve (AUC) using tumour dimension (TD) as a single marker to predict TC. We searched for the TD cutoff value with the highest combined sensitivity and specificity predicting TC. Univariate and multivariate logistic regression analysis were performed. Internal validation (bootstrap; N=1000 samples)) was performed.
Results:
A total of 144 patients were included. No patient had elevated pre-operative tumour markers. Overall, 74 of the 144 men (51.4%) were diagnosed with TC. On ROC analysis, the lesion diameter had an AUC of 0.76 (95% CI 0.67-0.84, p=0.01) to predict TC. At the best cutoff of 10 mm the diameter of the lesion had 64% sensitivity, 78% specificity (Figure1). The Multivariate-analysis, including age, clinical presentation, TD cutoff, and the number of lesions, showed that the age (OR 0.45;95%;CI:0.007–0.13;p=0.048), the TD-cutoff (OR 1.84;95%CI:0.504–3.83;p=0.01) and presence of vascularisation within the lesion on ultrasound imaging (OR:2.73;95%;CI0.857–17.53;p=0.01) were predictors of malignancy.
Conclusions:
Our study confirms that the majority of STMs are benign. TD is an independent predictor of TC. Patients with a TD exceeding the cutoff of 10 mm are more likely to be diagnosed with TC.
In this study we evaluated predictive markers for testicular cancer (TC) in patients with indeterminate small testicular masses (STM) often found on routine ultrasound.
Patients & Methods:
We retrospectively analysed the records of patients who underwent testicular biopsy or orchidectomy for STMs. All patients with testicular lesions smaller than 2 cm on ultrasound were included in the study. ROC curve was used to evaluate the area under the curve (AUC) using tumour dimension (TD) as a single marker to predict TC. We searched for the TD cutoff value with the highest combined sensitivity and specificity predicting TC. Univariate and multivariate logistic regression analysis were performed. Internal validation (bootstrap; N=1000 samples)) was performed.
Results:
A total of 144 patients were included. No patient had elevated pre-operative tumour markers. Overall, 74 of the 144 men (51.4%) were diagnosed with TC. On ROC analysis, the lesion diameter had an AUC of 0.76 (95% CI 0.67-0.84, p=0.01) to predict TC. At the best cutoff of 10 mm the diameter of the lesion had 64% sensitivity, 78% specificity (Figure1). The Multivariate-analysis, including age, clinical presentation, TD cutoff, and the number of lesions, showed that the age (OR 0.45;95%;CI:0.007–0.13;p=0.048), the TD-cutoff (OR 1.84;95%CI:0.504–3.83;p=0.01) and presence of vascularisation within the lesion on ultrasound imaging (OR:2.73;95%;CI0.857–17.53;p=0.01) were predictors of malignancy.
Conclusions:
Our study confirms that the majority of STMs are benign. TD is an independent predictor of TC. Patients with a TD exceeding the cutoff of 10 mm are more likely to be diagnosed with TC.
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