SWENOTECA clinical stage I NSGCT management programme
Does vascular invasion identify patients with sufficiently high relapse risk to justify adjuvant BEP in stage I non-seminoma?
What changes for patients?
SWENOTECA demonstrated why pathology matters in stage I NSGCT: among patients managed with surveillance, relapse was 41.7% with vascular invasion versus 13.2% without it. After one course of BEP, relapse was 3.2% in vascular-invasion-positive patients and 1.3% in vascular-invasion-negative patients. Because treatment allocation was not randomized, these absolute differences should not be converted into a causal NNT. NNT is therefore not assigned as a trial-level causal estimate.
NNT: Not applicable; non-randomized risk-adapted programme
One-cycle BEP toxicity
NNH: Not quantifiable from this nonrandomized programme; chemotherapy burden should be discussed against relapse risk
Risk stratification: Surveillance relapse 41.7% with vascular invasion vs 13.2% without
Prospective management programme; treatment allocation was not randomized
SWENOTECA supports risk-adapted surveillance and one-cycle BEP for stage I NSGCT, with relapse risk strongly associated with vascular invasion.
- Tandstad T, et al. J Clin Oncol. 2009;27:2122–2128.
- Tandstad T, et al. Ann Oncol. 2014;25:2167–2173.
- Primary publication / source
- Primary publication / source