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

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

Research output: Contribution to journalArticle

47 Scopus citations

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

Keywords

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

ASJC Scopus subject areas

  • Urology

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