The predictive value of serum tumor markers for pathologic findings after chemotherapy for primary mediastinal nonseminomatous germ cell tumors

作者：Laura Kruter, K. Kesler, Ming Yu, Zane T. Hammoud, Karen M. Rieger, L H Einhorn · 发表于：Journal of Clinical Oncology · 年份：2008 · DOI：10.1200/jco.2008.26.15_suppl.5087 · 被引用次数：6 · 研究领域：Testicular diseases and treatments、Sarcoma Diagnosis and Treatment、Neuroblastoma Research and Treatments

5087 Background: While data exists on the predictive value of serum tumor markers (STM) alpha-fetoprotein and human chorionic gonadotropin for postchemotherapy pathology in testicular nonseminomatous germ cell tumors (NSGCT), similar data for primary mediastinal NSGCT (PMNSGCT) have not been reported. We undertook a study of PMNSGCT patients who received cisplatin-based chemotherapy followed by surgery to investigate the relationship between preoperative STM values and surgical pathology. Methods: From 1981–2007, 166 PMNSGCT patients who presented to our institution for surgical therapy following chemotherapy were retrospectively reviewed. Multiple variables were analyzed with respect to preoperative STM levels and the “worst” pathology identified within the residual mass {noncancer (necrosis/teratoma, 59%, n=97), persistent NSGCT with or without malignant transformation of teratoma to nongerm cell cancer (NGCCA) (31%, n=52), or pure NGCCA (10%, n=17). Results: Elevation of either STM was present in 40% (n=66) patients at the time of surgery however only 59% of these patients demonstrated pathologic evidence of malignancy with persistent NGSCT (n=34) or pure NGCCA (n=5). Thirty-seven patients had a documented rise in STM prior to surgery and demonstrated pathologic evidence of malignancy in 25 (67%) cases. All, but only 8, patients with either STM level > 1,000 uniformly demonstrated pathologic evidence of persistent NSGCT. The overall predictive value of either STM elevation...