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Significance of elevated preoperative alpha-fetoprotein in postchemotherapy residual tumor resection for the disseminated germ cell tumors.
J Surg Oncol. 2006 Dec 01; 94(7):619-23.JS

Abstract

BACKGROUND AND OBJECTIVES

The purpose of the study is to determine the significance of elevated serum alpha-fetoprotein (AFP) in the setting prior to residual tumor resection (RTR) following chemotherapy for metastatic germ cell tumor in terms of the prediction of histology of the specimen and postoperative survival.

METHODS

We conducted a retrospective review of 68 patients undergoing RTR for metastatic nonseminomatous germ cell tumor or extragonadal germ cell tumor after at least a first-line chemotherapy. Pretreatment and postchemotherapy serum markers were evaluated in association with other clinical findings including results of pathological examination of RTR specimen and surgical outcome.

RESULTS

Of the 68 study patients, 54 (79%) and 45 (66%) had positive AFP and beta-human chorionic gonadotropin (beta-HCG) in pretreatment settings. Rates of presence of residual malignant cell in RTR specimen were similar between patients with normal AFP (7/28 or 25%) and with mildly elevated (10-30 ng/ml) AFP (3/11 or 27%). In 26 patients who had residual viable malignancy in RTR specimen, patients with preoperative positive AFP had significantly better survival (P = 0.02) compared to those with preoperative positive beta-HCG.

CONCLUSIONS

Sole and mild elevation of AFP is not always associated with postoperative poor prognosis. It should be carefully considered individually whether a mild elevation of AFP after chemotherapy represents residual malignancy or benign pathogenesis.

Authors+Show Affiliations

Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17111392

Citation

Kobayashi, Takashi, et al. "Significance of Elevated Preoperative Alpha-fetoprotein in Postchemotherapy Residual Tumor Resection for the Disseminated Germ Cell Tumors." Journal of Surgical Oncology, vol. 94, no. 7, 2006, pp. 619-23.
Kobayashi T, Kawakita M, Terachi T, et al. Significance of elevated preoperative alpha-fetoprotein in postchemotherapy residual tumor resection for the disseminated germ cell tumors. J Surg Oncol. 2006;94(7):619-23.
Kobayashi, T., Kawakita, M., Terachi, T., Habuchi, T., Ogawa, O., & Kamoto, T. (2006). Significance of elevated preoperative alpha-fetoprotein in postchemotherapy residual tumor resection for the disseminated germ cell tumors. Journal of Surgical Oncology, 94(7), 619-23.
Kobayashi T, et al. Significance of Elevated Preoperative Alpha-fetoprotein in Postchemotherapy Residual Tumor Resection for the Disseminated Germ Cell Tumors. J Surg Oncol. 2006 Dec 1;94(7):619-23. PubMed PMID: 17111392.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Significance of elevated preoperative alpha-fetoprotein in postchemotherapy residual tumor resection for the disseminated germ cell tumors. AU - Kobayashi,Takashi, AU - Kawakita,Mutsushi, AU - Terachi,Toshiro, AU - Habuchi,Tomonori, AU - Ogawa,Osamu, AU - Kamoto,Toshiyuki, PY - 2006/11/18/pubmed PY - 2006/12/21/medline PY - 2006/11/18/entrez SP - 619 EP - 23 JF - Journal of surgical oncology JO - J Surg Oncol VL - 94 IS - 7 N2 - BACKGROUND AND OBJECTIVES: The purpose of the study is to determine the significance of elevated serum alpha-fetoprotein (AFP) in the setting prior to residual tumor resection (RTR) following chemotherapy for metastatic germ cell tumor in terms of the prediction of histology of the specimen and postoperative survival. METHODS: We conducted a retrospective review of 68 patients undergoing RTR for metastatic nonseminomatous germ cell tumor or extragonadal germ cell tumor after at least a first-line chemotherapy. Pretreatment and postchemotherapy serum markers were evaluated in association with other clinical findings including results of pathological examination of RTR specimen and surgical outcome. RESULTS: Of the 68 study patients, 54 (79%) and 45 (66%) had positive AFP and beta-human chorionic gonadotropin (beta-HCG) in pretreatment settings. Rates of presence of residual malignant cell in RTR specimen were similar between patients with normal AFP (7/28 or 25%) and with mildly elevated (10-30 ng/ml) AFP (3/11 or 27%). In 26 patients who had residual viable malignancy in RTR specimen, patients with preoperative positive AFP had significantly better survival (P = 0.02) compared to those with preoperative positive beta-HCG. CONCLUSIONS: Sole and mild elevation of AFP is not always associated with postoperative poor prognosis. It should be carefully considered individually whether a mild elevation of AFP after chemotherapy represents residual malignancy or benign pathogenesis. SN - 0022-4790 UR - https://www.unboundmedicine.com/medline/citation/17111392/Significance_of_elevated_preoperative_alpha_fetoprotein_in_postchemotherapy_residual_tumor_resection_for_the_disseminated_germ_cell_tumors_ L2 - https://doi.org/10.1002/jso.20418 DB - PRIME DP - Unbound Medicine ER -