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Annals of Surgical Oncology, Vol 4, Issue 4 321-327, Copyright © 1997 by Society of Surgical Oncology

ARTICLES

Importance of a new tumor marker TRA-1-60 in the follow-up of patients with clinical stage I nonseminomatous testicular germ cell tumors

M. E. Gels, J. Marrink, P. Visser, D. T. Sleijfer, J. H. Droste, H. J. Hoekstra, P. W. Andrews and H. Schraffordt Koops
Department of Surgical Oncology, University Hospital Groningen, The Netherlands.

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.


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Copyright © 1997 by the Society of Surgical Oncology.