Failure patterns of nonseminomatous testicular germ cell tumors: radiographic analysis of 51 cases.
A retrospective analysis was performed of 51 consecutive cases of treatment failure (tumor recurrence) of nonseminomatous germ cell tumors. Twelve patients with clinical stage I disease relapsed after lymph node dissection; 39 with stage II or III disease relapsed after chemotherapy. Routine follow-up consisted of monthly chest radiography and determination of serum tumor marker levels (alpha-fetoprotein and human chorionic gonadotropin), as well as abdominal computed tomography every 6 months. The median recurrence interval was 3 months; 96% of the relapses occurred within 2 years. In 61% of patients, recurrence was in the initial disease site only, in 26% it was in both new and initial sites, and in 13% it was in new sites only. At the time of treatment failure, 47 (92%) of the patients had positive radiologic studies and 44 (86%) had positive serum marker levels. Nine (18%) had positive radiologic studies only, and four (8%) had positive serum marker levels only. The analysis demonstrated the complementary role of radiologic studies and serum tumor-marker assays in detecting treatment failure.
D000293:Adolescent; D000328:Adult; D002648:Child; D006063:Chorionic Gonadotropin / Q000032:analysis; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009373:Neoplasms, Germ Cell and Embryonal / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000556:secondary / Q000628:therapy; D011859:Radiography; D012189:Retrospective Studies; D013736:Testicular Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000628:therapy; D000509:alpha-Fetoproteins / Q000032:analysis
D006063:Chorionic Gonadotropin; D000509:alpha-Fetoproteins