The predictive value of pre-orchidectomy serum tumor markers in non seminomatous germ cell tumors of the testis (N.S.G.C.T.T.).
A.F.P. and B.H.C.G. serum levels were measured using a radio-immunoassay in 22 patients with a N.S.G.C.T.T. before and 15 days after orchidectomy. The results were confronted to the stage of the disease as determined by R.P.L.N.D. in the absence of gross metastatic disease. 4 of 6 patients with normal tumor markers had stage II or III disease, and 2 of 7 in whom the markers returned to normal were stage II. Pre-orchidectomy A.F.P. levels over 100 ng/ml are consistent with metastatic disease as well as vascular and/or cord involvement irrespective of the markers status. These results should be born in mind when deciding a simple surveillance policy in clinical stage I N.S.G.C.T.T. Serum tumor markers, alfa foetoprotein (A.F.P.) and the B fraction of human choriogonadotropin (B.H.C.G) are commonly used to monitor surveillance as well as therapeutic response in patients with N.S.G.C.T.T. It is however well known that 30% of the patients with stage IIa, IIb, N.S.G.C.T.T. have normal post-orchidectomy serum markers (SKINNER). These false negative which may proceed from absence or undetectable tumor markers secretion by the metastases, question the safety of the wait and see policy based on serial serum markers determination as well as abdominal and thoracic C.T. Scan. Nevertheless, the level of pre-orchidectomy serum tumor markers as well as their evolution after orchidectomy may be more meaningful.
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Boccon-Gibod
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Le Doze
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Steg
D000293:Adolescent; D000328:Adult; D006063:Chorionic Gonadotropin / Q000097:blood*; D018997:Chorionic Gonadotropin, beta Subunit, Human; D006801:Humans; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000097:blood* / Q000601:surgery; D009919:Orchiectomy; D010446:Peptide Fragments / Q000097:blood*; D013736:Testicular Neoplasms / Q000097:blood* / Q000601:surgery; D000509:alpha-Fetoproteins / Q000032:analysis*
D006063:Chorionic Gonadotropin; D018997:Chorionic Gonadotropin, beta Subunit, Human; D010446:Peptide Fragments; D000509:alpha-Fetoproteins