Value of tumor markers in nonseminomatous germ cell tumor of the testis.

We herein report 8 years experience in the management of nonseminomatous germ cell tumor of the testis with 2 serum markers: alpha-fetoprotein (AFP) and human chorionic gonadotropin (hCG)). In the first 4-year period (group I) marker status was correlated retrospectively to the positivity of nodes and response to treatment. Of the 81 patients in group I, 22, 29 and 30 were in stages I, IIab, and IIc, III and IV, respectively. Of them, 5, 25 and 24 from the respective stages showed raised markers, while 17, 4 and 6 of the same stages had normal markers. The accuracy of the markers in predicting the positivity of the nodes and response to treatment ranged from 80 to 92% in different stages. In the second 4-year period (group II) markers were included in staging. Of the 85 patients in this group, 31 were classified as stage I; however, 25 of them had normal markers and 6 had raised markers (subcategorized as IM). Of the remaining 54 patients, 15 were in stage IIab and 39 in stages IIc, III and IV. In the final analysis, 3-year survival was 66% in stage IM as compared to 100% in the remaining stage I patients and 86% in stage IIab, indicating the aggressive nature of IM disease. Amongst stage IIc, III and IV patients, 28 (71%) patients responded to treatment and 3-year survival in them was 71% (20/28). Of the remaining 11 patients who did not respond to treatment in the form of persistently raised markers, the 3-year survival was 18% (2/11).(ABSTRACT TRUNCATED AT 250 WORDS)