Utility of serum tumor markers during surveillance for stage I seminoma.
Cancer
; 118(21): 5245-50, 2012 Nov 01.
Article
in En
| MEDLINE
| ID: mdl-22517478
ABSTRACT
BACKGROUND:
The serum tumor markers α-fetoprotein (AFP), ß-human chorionic gonadotropin (HCG), and lactate dehydrogenase (LDH) are often measured as part of surveillance protocols in patients with stage I seminoma. In this study, the authors evaluated the utility of routine measurement of these markers in the detection of disease relapse.METHODS:
Data were gathered from a prospectively maintained database of patients who underwent surveillance for stage I testicular seminoma diagnosed between 1982 and 2005 at Princess Margaret Hospital. Patients were followed on a predefined schedule with physical examination (PE), serum tumor markers, abdominopelvic computed tomography, and chest x-rays. The records of patients who relapsed were examined for details of imaging and serum tumor markers throughout the period of follow-up until the time of relapse.RESULTS:
Of the 527 patients who were managed by surveillance, 75 patients (14%) relapsed at a median follow-up of 72 months. Of these, 65 patients relapsed within the first 3 years and had routine serum tumor markers measured. In total, 11 patients had abnormal tumor markers at the time of relapse (AFP, 0 patients; HCG, 6 patients; LDH, 4 patients; and HCG and LDH, 1 patient). Only 1 patient had an elevated tumor marker (LDH) before relapse, as defined by an abnormal imaging study (n = 64) or physical examination (n = 1), for which the treatment and outcome were not affected.CONCLUSIONS:
Serum tumor marker levels did not aid in the early diagnosis of disease relapse in patients with stage I seminoma who were managed with surveillance. The current results indicated that routine measurement of serum tumor markers can be discontinued safely in seminoma surveillance schedules.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Testicular Neoplasms
/
Alpha-Fetoproteins
/
Biomarkers, Tumor
/
Seminoma
/
Chorionic Gonadotropin
/
L-Lactate Dehydrogenase
Type of study:
Evaluation_studies
/
Guideline
/
Screening_studies
Limits:
Humans
/
Male
Language:
En
Journal:
Cancer
Year:
2012
Type:
Article
Affiliation country:
Canada