title: Prognostic value of BHCG and local tumor invasion in stage I seminoma of the testis.
abstract: Approximately 10-15% of patients with stage 1 pure seminoma of the testis have an elevated preorchiectomy serum beta human chorionic gonadotropin level [1-4]. The prognostic significance of this elevation is unknown. We performed a multi-institutional retrospective review of 332 men with stage I pure seminoma of the testis and evaluated the prognostic significance of this elevation and the prognostic value of local invasion of the primary tumor. Twenty-five of 191 evaluable patients (13%) had elevated preorchiectomy beta human chorionic gonadotropin. All normalized postoperatively and are alive without evidence of disease with a median follow-up of 50 months (range 1-124 mo). Of 191 patients, 190 (99.5%) are alive and free of disease. One patient underwent salvage chemotherapy for a chest recurrence, and he is alive and free of disease at 72 months. We conclude that elevated preorchiectomy serum beta human chorionic gonadotropin level and local invasion of the primary tumor do not portend a poor prognosis in patients with clinical stage I pure seminoma of the testis.
authors.affiliation: Department of Urology, Madigan Army Medical Center, Tacoma, Washington 98431-5000, USA.
authors.forename: B F
authors.initials: BF
authors.lastname: Schwartz
authors.forename: R
authors.initials: R
authors.lastname: Auman
authors.forename: S J
authors.initials: SJ
authors.lastname: Peretsman
authors.forename: J W
authors.initials: JW
authors.lastname: Moul
authors.forename: G E
authors.initials: GE
authors.lastname: Deshon
authors.forename: J
authors.initials: J
authors.lastname: Hernandez
authors.forename: R A
authors.initials: RA
authors.lastname: Rozanski
authors.forename: J B
authors.initials: JB
authors.lastname: Thrasher
mesh_terms: D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000032:analysis*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D006801:Humans; D008297:Male; D009919:Orchiectomy; D011379:Prognosis; D012189:Retrospective Studies; D018239:Seminoma / Q000378:metabolism / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D013736:Testicular Neoplasms / Q000378:metabolism / Q000401:mortality / Q000473:pathology* / Q000601:surgery
chemical_list: D018997:Chorionic Gonadotropin, beta Subunit, Human