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Statistical analyses were performed with the Stata software package (version 8.2; Stata Corp., College Station, Tex), all tests were 2-sided, and P values http://www.selleckchem.com/products/BI-2536.html 26 patients who had clinical stage IA NSGCT, 21 patients had either embryonal and/or teratoma features in the primary tumor. Overall, positive lymph nodes were identified in 75 patients, including 56 patients (75%) with viable tumor only, 10 patients (13%) with viable tumor and teratoma, and 9 patients (12%) with teratoma only. Positive lymph nodes were identified in 2 patients (8%) with clinical stage IA NSGCT, in 34 patients (23%) with clinical stage IB NSGCT, and in 39 (48%) patients with clinical stage IIA NSGCT. http://www.selleck.cn/products/gsk126.html A summary of lymph node counts by region is detailed in Table 2. The median (IQR) total lymph node count was 38 (IQR, 27-53 total lymph nodes). In the subset of 129 patients who were treated over the last 5 years (from 2004 through 2008), the median (IQR) total lymph node count increased to 48 (IQR, 34-61 total lymph nodes). Features that were predictive of a higher total lymph node count on univariate and multivariate analyses included year of surgery, surgeon, and clinical stage (Table 3). On average, 2.5 additional lymph nodes were counted with each increasing year during the http://www.selleckchem.com/products/Cyclopamine.html study time frame, 8.3 additional lymph nodes were counted if a high-volume surgeon performed the RPLND, and 5.3 additional lymph nodes were counted if the clinical stage was IIA versus I. Although high-volume pathologists were significantly more likely to have higher lymph node counts on univariate analysis, after adjusting for year of surgery, surgeon, and clinical stage, the pathologist no longer was associated significantly with higher lymph node counts (P = .3). Then, we evaluated the features associated with positive lymph nodes (vs pathologically negative lymph nodes [pN0]) at the time of RPLND. Clinical stage and total lymph node count were significantly associated with positive lymph nodes, as demonstrated in Table 4, whereas year of surgery and surgeon were not. The odds of finding positive lymph nodes were >3 for patients who had clinical stage II NSGCT compared with patients who had clinical stage I NSGCT (P