The management of patients with clinical stage I nonseminomatous testicular tumors and persistently elevated serologic markers

Scott B. Saxman, Craig R. Nichols, Richard Foster, Jonathan E. Messemer, John P. Donohue, Lawrence Einhorn

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

Purpose: We reviewed our experience with patients who had nonseminomatous germ cell tumors clinically limited to the testis and persistently elevated serum human chorionic gonadotropin (HCG) or α-fetoprotein (AFP) levels after orchiectomy. Materials and Methods: All patients had clinical stage I disease with persistently elevated tumor markers that were not decreasing in accordance with the expected metabolic decay rate at retroperitoneal lymph node dissection. Results: Of 30 patients identified 3 had elevated AFP, 24 had elevated HCG and 3 had elevation of both markers. Of the 6 patients with elevated AFP with or without concurrent HCG elevation 5 (83%) had relapse and required chemotherapy, as did 6 of 24 (25%) with HCG elevation. Conclusions: Patients with persistently elevated AFP after orchiectomy should be treated initially with chemotherapy. Although the majority of patients with elevated serum HCG were disease-free after surgery alone, a fourth of these patients still had relapse and required chemotherapy.

Original languageEnglish
Pages (from-to)587-589
Number of pages3
JournalJournal of Urology
Volume155
Issue number2
DOIs
StatePublished - Feb 1996

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Testicular Neoplasms
Chorionic Gonadotropin
Orchiectomy
Drug Therapy
Fetal Proteins
Recurrence
Tumor Biomarkers
Lymph Node Excision
Serum
Testis

Keywords

  • lymph node excision
  • retroperitoneal neoplasms
  • testicular neoplasms
  • tumor markers, biological

ASJC Scopus subject areas

  • Urology

Cite this

The management of patients with clinical stage I nonseminomatous testicular tumors and persistently elevated serologic markers. / Saxman, Scott B.; Nichols, Craig R.; Foster, Richard; Messemer, Jonathan E.; Donohue, John P.; Einhorn, Lawrence.

In: Journal of Urology, Vol. 155, No. 2, 02.1996, p. 587-589.

Research output: Contribution to journalArticle

Saxman, Scott B. ; Nichols, Craig R. ; Foster, Richard ; Messemer, Jonathan E. ; Donohue, John P. ; Einhorn, Lawrence. / The management of patients with clinical stage I nonseminomatous testicular tumors and persistently elevated serologic markers. In: Journal of Urology. 1996 ; Vol. 155, No. 2. pp. 587-589.
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