Should an elevated human chorionic gonadotropin titer alter therapy for seminoma?

We reviewed the clinical courses of 55 patients with pure seminoma of the testis to determine the influence of elevated levels of beta-human chorionic gonadotropin on prognosis. Of 44 patients with stage I and 11 with stage IIA seminomas 42 and 36 per cent, respectively, had elevated gonadotropin levels after orchiectomy and before radiotherapy. At followup, ranging from 12 to 64 months, 54 patients (98 per cent) were free of disease. We concluded that an elevated gonadotropin level after orchiectomy is not a significant prognostic indicator and that these patients should be treated with standard radiotherapy techniques.