Significance of Primary Tumor Size and Preorchiectomy Serum Tumor Marker Level in Predicting Pathologic Stage at Retroperitoneal Lymph Node Dissection in Clinical Stage A Nonseminomatous Germ Cell Tumors

Stephen D.W. Beck, Richard S. Foster, Richard Bihrle, John P. Donohue

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objectives: To determine whether the size of the primary tumor and degree of preorchiectomy serum alpha-fetoprotein (AFP) and beta-human chorionic gonadotropin (β-hCG) elevation predict for retroperitoneal pathologic findings in patients with clinical Stage A nonseminomatous germ cell tumor undergoing primary retroperitoneal lymph node dissection. Methods: The testicular cancer database was queried to identify patients with clinical Stage A nonseminomatous germ cell tumor with normalization of serum tumor markers after orchiectomy who had undergone retroperitoneal lymph node dissection. A total of 779 patients were identified. The preorchiectomy serum tumor marker level was recorded and categorized into the following subsets: AFP: less than 20 (normal), 20 to 100, 100 to 1000, and more than 1000 ng/dL; and β-hCG: less than 5.0 (normal), 5 to 100, 100 to 1000, and more than 1000. The association between AFP, β-hCG, and primary tumor size and retroperitoneal pathologic findings was determined. Results: The retroperitoneal pathologic examination revealed metastatic disease in 207 patients (26.6%). The preorchiectomy serum β-hCG level, as a categorical variable, was not predictive of positive retroperitoneal pathologic findings (P = 0.187). The preorchiectomy serum AFP did predict for positive retroperitoneal pathologic findings, with lower serum AFP levels associated with a greater incidence of retroperitoneal metastasis (P <0.001). The primary tumor size was not predictive of positive retroperitoneal pathologic findings (P = 0.113). Conclusions: Neither the primary tumor size nor the preorchiectomy β-hCG level was predictive of retroperitoneal metastases. However, a normal preorchiectomy AFP level was associated with a greater incidence of retroperitoneal metastases.

Original languageEnglish (US)
Pages (from-to)557-559
Number of pages3
JournalUrology
Volume69
Issue number3
DOIs
StatePublished - Mar 1 2007

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alpha-Fetoproteins
Tumor Biomarkers
Lymph Node Excision
Biomarkers
Neoplasms
Neoplasm Metastasis
Serum
Orchiectomy
Incidence
Testicular Neoplasms
Chorionic Gonadotropin
Nonseminomatous germ cell tumor
Databases

ASJC Scopus subject areas

  • Urology

Cite this

@article{de38922af1e242bdabd4de29cd99db3f,
title = "Significance of Primary Tumor Size and Preorchiectomy Serum Tumor Marker Level in Predicting Pathologic Stage at Retroperitoneal Lymph Node Dissection in Clinical Stage A Nonseminomatous Germ Cell Tumors",
abstract = "Objectives: To determine whether the size of the primary tumor and degree of preorchiectomy serum alpha-fetoprotein (AFP) and beta-human chorionic gonadotropin (β-hCG) elevation predict for retroperitoneal pathologic findings in patients with clinical Stage A nonseminomatous germ cell tumor undergoing primary retroperitoneal lymph node dissection. Methods: The testicular cancer database was queried to identify patients with clinical Stage A nonseminomatous germ cell tumor with normalization of serum tumor markers after orchiectomy who had undergone retroperitoneal lymph node dissection. A total of 779 patients were identified. The preorchiectomy serum tumor marker level was recorded and categorized into the following subsets: AFP: less than 20 (normal), 20 to 100, 100 to 1000, and more than 1000 ng/dL; and β-hCG: less than 5.0 (normal), 5 to 100, 100 to 1000, and more than 1000. The association between AFP, β-hCG, and primary tumor size and retroperitoneal pathologic findings was determined. Results: The retroperitoneal pathologic examination revealed metastatic disease in 207 patients (26.6{\%}). The preorchiectomy serum β-hCG level, as a categorical variable, was not predictive of positive retroperitoneal pathologic findings (P = 0.187). The preorchiectomy serum AFP did predict for positive retroperitoneal pathologic findings, with lower serum AFP levels associated with a greater incidence of retroperitoneal metastasis (P <0.001). The primary tumor size was not predictive of positive retroperitoneal pathologic findings (P = 0.113). Conclusions: Neither the primary tumor size nor the preorchiectomy β-hCG level was predictive of retroperitoneal metastases. However, a normal preorchiectomy AFP level was associated with a greater incidence of retroperitoneal metastases.",
author = "Beck, {Stephen D.W.} and Foster, {Richard S.} and Richard Bihrle and Donohue, {John P.}",
year = "2007",
month = "3",
day = "1",
doi = "10.1016/j.urology.2006.12.011",
language = "English (US)",
volume = "69",
pages = "557--559",
journal = "Urology",
issn = "0090-4295",
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number = "3",

}

TY - JOUR

T1 - Significance of Primary Tumor Size and Preorchiectomy Serum Tumor Marker Level in Predicting Pathologic Stage at Retroperitoneal Lymph Node Dissection in Clinical Stage A Nonseminomatous Germ Cell Tumors

AU - Beck, Stephen D.W.

AU - Foster, Richard S.

AU - Bihrle, Richard

AU - Donohue, John P.

PY - 2007/3/1

Y1 - 2007/3/1

N2 - Objectives: To determine whether the size of the primary tumor and degree of preorchiectomy serum alpha-fetoprotein (AFP) and beta-human chorionic gonadotropin (β-hCG) elevation predict for retroperitoneal pathologic findings in patients with clinical Stage A nonseminomatous germ cell tumor undergoing primary retroperitoneal lymph node dissection. Methods: The testicular cancer database was queried to identify patients with clinical Stage A nonseminomatous germ cell tumor with normalization of serum tumor markers after orchiectomy who had undergone retroperitoneal lymph node dissection. A total of 779 patients were identified. The preorchiectomy serum tumor marker level was recorded and categorized into the following subsets: AFP: less than 20 (normal), 20 to 100, 100 to 1000, and more than 1000 ng/dL; and β-hCG: less than 5.0 (normal), 5 to 100, 100 to 1000, and more than 1000. The association between AFP, β-hCG, and primary tumor size and retroperitoneal pathologic findings was determined. Results: The retroperitoneal pathologic examination revealed metastatic disease in 207 patients (26.6%). The preorchiectomy serum β-hCG level, as a categorical variable, was not predictive of positive retroperitoneal pathologic findings (P = 0.187). The preorchiectomy serum AFP did predict for positive retroperitoneal pathologic findings, with lower serum AFP levels associated with a greater incidence of retroperitoneal metastasis (P <0.001). The primary tumor size was not predictive of positive retroperitoneal pathologic findings (P = 0.113). Conclusions: Neither the primary tumor size nor the preorchiectomy β-hCG level was predictive of retroperitoneal metastases. However, a normal preorchiectomy AFP level was associated with a greater incidence of retroperitoneal metastases.

AB - Objectives: To determine whether the size of the primary tumor and degree of preorchiectomy serum alpha-fetoprotein (AFP) and beta-human chorionic gonadotropin (β-hCG) elevation predict for retroperitoneal pathologic findings in patients with clinical Stage A nonseminomatous germ cell tumor undergoing primary retroperitoneal lymph node dissection. Methods: The testicular cancer database was queried to identify patients with clinical Stage A nonseminomatous germ cell tumor with normalization of serum tumor markers after orchiectomy who had undergone retroperitoneal lymph node dissection. A total of 779 patients were identified. The preorchiectomy serum tumor marker level was recorded and categorized into the following subsets: AFP: less than 20 (normal), 20 to 100, 100 to 1000, and more than 1000 ng/dL; and β-hCG: less than 5.0 (normal), 5 to 100, 100 to 1000, and more than 1000. The association between AFP, β-hCG, and primary tumor size and retroperitoneal pathologic findings was determined. Results: The retroperitoneal pathologic examination revealed metastatic disease in 207 patients (26.6%). The preorchiectomy serum β-hCG level, as a categorical variable, was not predictive of positive retroperitoneal pathologic findings (P = 0.187). The preorchiectomy serum AFP did predict for positive retroperitoneal pathologic findings, with lower serum AFP levels associated with a greater incidence of retroperitoneal metastasis (P <0.001). The primary tumor size was not predictive of positive retroperitoneal pathologic findings (P = 0.113). Conclusions: Neither the primary tumor size nor the preorchiectomy β-hCG level was predictive of retroperitoneal metastases. However, a normal preorchiectomy AFP level was associated with a greater incidence of retroperitoneal metastases.

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