4.0 Letter

The Value of Tumour Markers in the Detection of Relapse-Lessons Learned from the Swiss Austrian German Testicular Cancer Cohort Study

期刊

EUROPEAN UROLOGY OPEN SCIENCE
卷 50, 期 -, 页码 57-60

出版社

ELSEVIER
DOI: 10.1016/j.euros.2023.01.013

关键词

Testicular cancer follow-up; Tumour markers; Beta human chorionic; gonadotropin; Alpha-fetoprotein; Lactate dehydrogenase

向作者/读者索取更多资源

The study assessed the validity of tumor markers in detecting relapse in testicular cancer patients and found that the accuracy of conventional tumor markers is limited, particularly lactate dehydrogenase (LDH) should be questioned in routine follow-up.
The tumour markers alpha-fetoprotein (AFP), beta human chorionic gonadotropin (BHCG), and lactate dehydrogenase (LDH) have established roles in the manage-ment and follow-up of testicular cancer. While a tumour marker rise can serve as an indicator of relapse, the frequency of false-positive marker events has not been studied systematically in larger cohorts. We assessed the validity of serum tumour markers for the detection of relapse in the Swiss Austrian German Testicular Cancer Cohort Study (SAG TCCS). This registry was set up to answer questions on the diag-nostic performance and impact of imaging and laboratory tests in the management of testicular cancer, and has included 948 patients between January 2014 and July 2021.A total of 793 patients with a median follow-up of 29.0 mo were included. In total, 71 patients (8.9%) had a proven relapse, which was marker positive in 31 patients (43.6%). Of all patients, 124 (15.6%) had an event of a false-positive marker elevation. The positive predictive value (PPV) of the markers was limited, highest for beta HCG (33.8%) and lowest for LDH (9.4%). PPV tended to increase with higher levels of elevation. These findings underline the limited accuracy of the conventional tumour markers to indicate or rule out a relapse. Especially, LDH as part of routine follow-up should be questioned. Patient summary: With the diagnosis of testicular cancer, the three tumour markers alpha-fetoprotein, beta human chorionic gonadotropin, and lactate dehydrogenase are routinely measured during follow-up to monitor for relapse. We demonstrate that these markers are often falsely elevated, and, by contrast, many patients do not have marker elevations despite a relapse. The results of this study can lead to improved use of these tumour markers during follow-up of testis cancer patients. (c) 2023 The Author(s). Published by Elsevier B.V. on behalf of European Association of Urology.

作者

我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。

评论

主要评分

4.0
评分不足

次要评分

新颖性
-
重要性
-
科学严谨性
-
评价这篇论文

推荐

暂无数据
暂无数据