Skip to main content
PMC home page
British Journal of Cancer logoLink to British Journal of Cancer
. 1990 Jun;61(6):916–918. doi: 10.1038/bjc.1990.205

Frequency of serum tumour marker monitoring in patients with non-seminomatous germ cell tumours.

M J Seckl 1, G J Rustin 1, K D Bagshawe 1
PMCID: PMC1971689  PMID: 1695522

Abstract

In patients relapsing on surveillance following orchidectomy for stage 1 non-seminomatous germ cell tumours, it is essential that treatment is initiated before they develop advanced disease with a poor prognosis. Patients who start chemotherapy with levels of human chorionic gonadotrophin (HCG) greater than 1,000 i.u. l-1 and/or alpha-fetoprotein (AFP) level greater than 500 ku l-1 have been shown to have a worse prognosis than patients with lower marker levels. We studied 64 patients between 1968 and 1987 with rising serial tumour markers. The potential time in which markers could rise to poor prognostic levels was calculated assuming an exponential rate of increase. Adverse levels were predicted in one patient (1.6%) within 7 days, in two patients (3.1%) within 14 days, in eight patients (12.5%) within 4 weeks and in 16 patients (25%) within 6 weeks. This suggests that, initially, weekly marker estimations should be performed on stage 1 surveillance patients. The extra cost to a specialist follow-up laboratory of weekly as opposed to the usual monthly marker measurements will be less than 33,600 pounds for every 400 patients on surveillance. One extra patient is likely to be cured for this sum.

Full text

PDF
916

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bosl G. J., Geller N. L., Cirrincione C., Vogelzang N. J., Kennedy B. J., Whitmore W. F., Jr, Vugrin D., Scher H., Nisselbaum J., Golbey R. B. Multivariate analysis of prognostic variables in patients with metastatic testicular cancer. Cancer Res. 1983 Jul;43(7):3403–3407. [PubMed] [Google Scholar]
  2. Crawford S. M., Rustin G. J., Begent R. H., Newlands E. S., Bagshawe K. D. Safety of surveillance in the management of stage I anaplastic germ cell tumours of the testis. Br J Urol. 1988 Mar;61(3):250–253. doi: 10.1111/j.1464-410x.1988.tb06389.x. [DOI] [PubMed] [Google Scholar]
  3. Freedman L. S., Parkinson M. C., Jones W. G., Oliver R. T., Peckham M. J., Read G., Newlands E. S., Williams C. J. Histopathology in the prediction of relapse of patients with stage I testicular teratoma treated by orchidectomy alone. Lancet. 1987 Aug 8;2(8554):294–298. doi: 10.1016/s0140-6736(87)90889-0. [DOI] [PubMed] [Google Scholar]
  4. Germa-Lluch J. R., Begent R. H., Bagshawe K. D. Tumour-marker levels and prognosis in malignant teratoma of the testis. Br J Cancer. 1980 Dec;42(6):850–855. doi: 10.1038/bjc.1980.332. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Javadpour N. The value of biologic markers in diagnosis and treatment of testicular cancer. Semin Oncol. 1979 Mar;6(1):37–47. [PubMed] [Google Scholar]
  6. Newlands E. S., Bagshawe K. D., Begent R. H., Rustin G. J., Crawford S. M., Holden L. Current optimum management of anaplastic germ cell tumours of the testis and other sites. Br J Urol. 1986 Jun;58(3):307–314. doi: 10.1111/j.1464-410x.1986.tb09061.x. [DOI] [PubMed] [Google Scholar]
  7. Nørgaard-Pedersen B., Schultz H. P., Arends J., Brincker H., Krag Jacobsen G., Lindeløv B., Rørth M., Svennekjaer I. L. Tumour markers in testicular germ cell tumours. Five-year experience from the DATECA Study 1976-1980. Acta Radiol Oncol. 1984;23(4):287–294. doi: 10.3109/02841868409136024. [DOI] [PubMed] [Google Scholar]
  8. Prognostic factors in advanced non-seminomatous germ-cell testicular tumours: results of a multicentre study. Report from the Medical Research Council Working Party on Testicular Tumours. Lancet. 1985 Jan 5;1(8419):8–11. [PubMed] [Google Scholar]
  9. Rustin G. J. Tumour markers in germ cell tumours. Br Med J (Clin Res Ed) 1986 Mar 15;292(6522):713–714. doi: 10.1136/bmj.292.6522.713. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Stoter G., Sylvester R., Sleijfer D. T., ten Bokkel Huinink W. W., Kaye S. B., Jones W. G., van Oosterom A. T., Vendrik C. P., Spaander P., de Pauw M. Multivariate analysis of prognostic factors in patients with disseminated nonseminomatous testicular cancer: results from a European Organization for Research on Treatment of Cancer Multiinstitutional Phase III Study. Cancer Res. 1987 May 15;47(10):2714–2718. [PubMed] [Google Scholar]

Articles from British Journal of Cancer are provided here courtesy of Cancer Research UK

RESOURCES