title: Importance of a new tumor marker TRA-1-60 in the follow-up of patients with clinical stage I nonseminomatous testicular germ cell tumors.
abstract: BACKGROUND
  TRA-1-60 is a new tumor marker for embryonal carcinoma-positive nonseminomatous testicular germ cell tumors (NSTGCT). Upper normal reference value (RV) and serum half-life (t1/2) were determined. The value was determined in the follow-up of 154 patients with stage I NSTGCT.
  
  
  METHODS
  TRA-1-60 was measured in normal controls (n = 100) to determine RV and in patients without recurrence for t1/2. In all patients, TRA-1-60 was determined at the time of orchidectomy. In 42 patients with recurrence, values were also evaluated 1 month before and at the time of computed tomography-confirmed recurrence. Predictive values and survival probability were examined and compared with values for alpha-fetoprotein (AFP) and human chorionic gonadotropin (hCG).
  
  
  RESULTS
  RV was 230 U/ml and t1/2 9.5 days. Elevated TRA-1-60 at the time of orchidectomy was not associated with recurrence. One month before recurrence, 21 of 42 patients had elevated TRA-1-60 levels (50%); 10 were negative for both AFP and hCG. At the time of recurrence, 24 patients had elevated TRA-1-60 levels (57.1%): 9 were negative for AFP/hCG. Patients with TRA-1-60 levels of > 500 U/ml had a poorer recurrence-free survival probability (p = 0.015).
  
  
  CONCLUSIONS
  TRA-1-60 is useful in the follow-up of stage 1 NSTGCT. The combination of AFP, hCG, and TRA-1-60 may improve the early detection of recurrence.
authors.affiliation: Department of Surgical Oncology, University Hospital Groningen, The Netherlands.
authors.forename: M E
authors.initials: ME
authors.lastname: Gels
authors.forename: J
authors.initials: J
authors.lastname: Marrink
authors.forename: P
authors.initials: P
authors.lastname: Visser
authors.forename: D T
authors.initials: DT
authors.lastname: Sleijfer
authors.forename: J H
authors.initials: JH
authors.lastname: Droste
authors.forename: H J
authors.initials: HJ
authors.lastname: Hoekstra
authors.forename: P W
authors.initials: PW
authors.lastname: Andrews
authors.forename: H
authors.initials: H
authors.lastname: Schraffordt Koops
mesh_terms: D000951:Antigens, Neoplasm / Q000097:blood*; D000954:Antigens, Surface; D014408:Biomarkers, Tumor / Q000097:blood*; D006063:Chorionic Gonadotropin / Q000032:analysis; D018237:Germinoma / Q000097:blood* / Q000473:pathology / Q000601:surgery; D006023:Glycoproteins / Q000276:immunology*; D006207:Half-Life; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000097:blood; D009367:Neoplasm Staging; D009919:Orchiectomy; D011509:Proteoglycans; D012016:Reference Values; D016019:Survival Analysis; D013736:Testicular Neoplasms / Q000097:blood* / Q000473:pathology / Q000601:surgery; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D000951:Antigens, Neoplasm; D000954:Antigens, Surface; D014408:Biomarkers, Tumor; D006063:Chorionic Gonadotropin; D006023:Glycoproteins; D011509:Proteoglycans; C107064:TRA-1-60 antigen, human; D000509:alpha-Fetoproteins