Dynamics of oncomarkers duringthe oncological treatment of testicular germinal cell tumours

Czech version

Authors: Z. Donátová ¹; J. Abrahámová ¹; I. Malbohan ²; M. Foldyna ¹; J. Nepomucká ¹
Authors‘ workplace: Onkologické oddělení, Fakultní Thomayerova nemocnice, Praha Přednosta: prof. MUDr. Jitka Abrahámová, DrSc. ; Ústav klinické biochemie a laboratorní diagnostiky, Všeobecná Fakultní nemocnice, Praha Přednosta: prof. MUDr. Tomáš Zima, DrSc., MBA. ²
Published in: Prakt. Lék. 2008; 88(1): 50-53
Category: Case Report

Overview

Testicular germ cell tumours (GCT) are highly curable though require proper management at all stages. GCTs are classified in two major subgroups: seminoma and non-seminoma. Serum concentrations of tumour markers –⁠ AFP, LDH and beta-HCG –⁠ are an integral part of the TNM classification system as the S category. Independent prognostic factors for progression-free survival for patients with GCT include pre-treatment levels of LDH, HCG and AFP, site of primary tumour (i.e. mediastinal vs. testis or retroperitoneal) and the presence of non-pulmonary visceral metastases (such as bone, brain or liver metastases). We describe representative dynamics of tumour marker levels in 4 patients with advanced GCT. Careful periodic check-ups are required following radiotherapy (for clinical stage I, IIA and IIB seminoma) and after chemotherapy (III stage seminoma, non-seminoma tumours) –⁠ which consist of chest X–ray, abdominal CT scan, PET scan, determination of serum concentration of AFP, HCG, LDH and a physical examination. An abnormal marker serum concentration may indicate late relapse.

Key words:
germ cell tumour, seminoma, non-seminoma, tumour marker, TNM classification.

Sources

1. Abrahámová, J., Povýšil, C., Dušek, L. a kol. Nádory varlat. Praha: Grada, 2008 (v tisku).

2. Abrahámová, J. Nádory varlat. Praha: Triton, 2001.

3. Abrahámová, J. Germinální nádory varlat. Referátový výběr® z onkologie, 24, 1/2007, s. 5–26.

4. Bosl, G.J., Bajorin, D.F, Sheinfeld, J. et. al. Cancer of the testis, In: De Vita, V. T., Hellman, S., Rosenberg, S. A. (eds.) Cancer. Principles and practices of oncology. 6th edition, Philadelphia: Lippincott-Raven, 2001, p. 1491–1518.

5. Fleming, I. et. al., eds. AJJC Cancer Staging Handbook. Philadelphia: Lippincott-Raven, 1998.

6. Hermanek, P., Hutter, R.P., Sobin, L.H., Wagber, G., Wittekind, Ch. (eds) TNM atlas, 5th edition, Heidelberg: Springer, 2005.

9. International Germ Cell Cancer Collaboration Group International germ cell consensus classification: A prognostic factor-based staging system for metastatic germ cell cancers. J. Clin. Oncol. 1997, 15, p. 594-603.

10. Klener, P., Abrahámová, J. Nádory mužských pohlavních orgánů. In. Klener, P.: Klinická onkologie, Praha: Galén, 2002.

11. Olenburg, J., Martin, J.M., Fossa, S.D. Late Relapses of Germ Cell Malignancies: Incidence Management, and Prognosis. J. Clin. Oncol. 2006, 24. p. 5503–5511.

12. Sonpavde, T.E., Roth, B.J. Management of Recurrent Testicular Germ cell Tumors. Oncologist 2007, 12 (1), p. 51–61.