Multivariable survival analysisIndiana experience

Eight factors significant on univariate analysis were entered into the multivariate regression analysis using the Cox proportional hazards model. Serum AFP higher than 1000 (five patients), bHCG higher than 1000 (four patients), and unresectable disease (three patients) were excluded from multivariable analysis because of small numbers. Four variables were determined to have independent prognostic significance for survival in the Cox model: bHCG status (rising versus declining or plateau), serum AFP level (continuous variable), redo RPLND, and germ-cell cancer in the surgical specimen (Table 3).

In subset analysis, retroperitoneal pathology, with a 5-year overall survival of 36.9%, 96.5%, and 100% for germ-cell cancer, teratoma, and fibrosis, respectively (P = .00001), was the single predictor of outcome on multivariable analysis for the 50 patients in the induction group. Significant variables predictive of outcome for the 64 patients in the salvage group are listed in Table 3. Pathology was not predictive of outcome in this group with no statistical difference in 5-year survival (29.6%, 40.4%, and 50%) for germ-cell cancer, teratoma, and fibrosis, respectively (P = .20).

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