Importance of a new tumor market TRA-1-60 in the follow-up of patients with clinical stage I nonseminomatous testicular germ cell tumors
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Background: TRA-1-60 is a new tumor marker for embryonal carcinoma-positive nonseminomatous testicular germ cell tumors (NSTGCT). Upper normal reference value (RV) and serum half-life (t1/2) were determined. The value was determined in the follow-up of 154 patients with stage I NSTGCT.
Methods: TRA-1-60 was measured in normal controls (n=100) to determine RV and in patients without recurrence for t1/2. In all patients, TRA-1-60 was determined at the time of orchidectomy. In 42 patients with recurrence, values were also evaluated 1 month before and at the time of computed tomography-confirmed recurrence. Predictive values and survival probability were examined and compared with values for α-fetoprotein (AFP) and human chorionic gonadotropin (hCG).
Results: RV was 230 U/ml and t1/2 9.5 days. Elevated TRA-1-60 at the time of orchidectomy was not associated with recurrence. One month before recurrence, 21 of 42 patients had elevated TRA-1-60 levels (50%); 10 were negative for both AFP and hCG. At the time of recurrence, 24 patients had elevated TRA-1-60 levels (57.1%); 9 were negative for AFP/hCG. Patients with TRA-1-60 levels of >500 U/ml had a poorer recurrence-free survival probability (p=0.015).
Conclusions: TRA-1-60 is useful in the follow-up of stage I NSTGCT. The combination of AFP, hCG, and TRA-1-60 may improve the early detection of recurrence.
- Read G, Johnson RJ, Wilkinson PM, Eddleston B. Prospective study of follow-up alone in stage I teratoma of the testis.Br Med J 1983;287:1503–5.
- Price P, Hogan SJ, Bliss JM, Horwich A. The growth rate of metastatic non-seminomatous germ cell testicular tumours measured by marker production doubling time — II. Prognostic significance in patients treated by chemotherapy.Eur J Cancer 1990;26:453–7.
- Hoskin P, Dilly S, Easton D, Horwich A, Hendry W, Peckham MJ. Prognostic factors in stage I non-seminomatous germ cell testicular tumors managed by orchiectomy and surveillance: implications for adjuvant chemotherapy.J Clin Oncol 1986;4:1031–6.
- Sesterhenn IA, Weiss RB, Mostofi FK, Stablein DM, Rowland RG, Falkson G, Rivkind SE, et al. Prognosis and other clinical correlates of pathologic review in stage I and II testicular carcinoma: a report from the Testicular Cancer Intergroup Study.J Clin Oncol 1992;10:69–78.
- Sturgeon JFG, Jewett MAS, Alison RE, Gospodarowicz MK, Blend R, Herman S, Richmond H, et al. Surveillance after orchidectomy for patients with clinical stage I nonseminomatous testis tumors.J Clin Oncol 1992;10:564–8.
- Toner GC, Geller NL, Tan C, Nisselbaum J, Bosl GJ. Serum tumor marker half-life during chemotherapy allows early prediction of complete response and survival in nonseminomatous germ cell tumors.Cancer Res 1990;50:5904–10.
- Stevens MJ, Norman AR, Dearnaley DP, Horwich A. Prognostic significance of early serum tumor marker half-life in metastatic testicular teratoma.J Clin Oncol 1995;13:87–92.
- Murphy BA, Motzer RJ, Mazumdar M, Vlamis V, Nisselbaum J, Bajorin D, Bosl G. Serum tumor marker decline is an early predictor of treatment outcome in germ cell tumor patients treated with cisplatin and ifosfamide salvage chemotherapy.Cancer 1994;73:2520–6.
- Suurmeijer AJH, Oosterhuis JW, Marrink J, de Bruin HWA, Schraffordt Koops H, Sleijfer DT, Fleuren GJ. Non-seminomatous germ cell tumors of the testis: analysis of AFP and HCG production by primary tumors and retroperitoneal lymph node metastases after PVB combination chemotherapy.Oncodev Biol Med 1983;4:289–308.
- Horwich A.Testicular Cancer: Investigation and Management. London: Chapman & Hall Medical, 1991.
- Andrews PW, Banting GS, Damjanov I, et al. Three monoclonal antibodies defining distinct differentiation antigens associated with different high molecular weight polypeptides on the surface of human embryonal carcinoma cells.Hybridoma 1984;3:347–61.
- Andrews PW, Damjanov I, Simon D, et al. Pluripotent embryonal carcinoma clones derived from the human teratocarcinoma cell line Tera-2.Lab Invest 1984;50:147–62.
- Marrink J, Andrews PW, van Brummen PJ, de Jong HF, Sleijfer DTh, Schraffordt Koops H, Oosterhuis JW. TRA-1-60: a new serum marker in patients with germ-cell tumors.Int J Cancer 1991;49:368–72.
- Gels ME, Hoekstra HJ, Sleijfer DT, Marrink J, de Bruin HWA, Molenaar WM, Freling NJM, et al. Detection of recurrence in patients with clinical stage I nonseminomatous testicular germ cell tumors and consequences for further follow-up: a single-center 10-year experience.J Clin Oncol 1995;13:1188–94.
- Peckham MJ, Barret A, McElwain TJ, Hendry WF. Combined management of malignant teratoma of the testis.Lancet 1979;2:267–70.
- Mostofi FK, Sobin LH. Histological typing of testis tumours. In:International Histological Classification of Tumours No. 16. Geneva: World Health Organization, 1977:1–39.
- Harmer MH.TNM Classification of Malignant Tumours. Geneva: Union Internationale Contre le Cancer, 1978:122–5.
- Einhorn LH, Donohue JP. Cis-diamminedichloroplatinum, vinblastine and bleomycin combination chemotherapy in disseminated testicular cancer.Ann Intern Med 1977;87:293–8.
- Stoter G, Vendrik CPJ, Struyvenberg A, Brouwers TM, Sleijfer DT, Schraffordt Koops H, van Oosterom H, et al. Combination chemotherapy with cis-diamminedichloroplatinum, vinblastine and bleomycin in advanced testicular non-seminoma.Lancet 1979;1:941–5.
- Andrews PW, Marrink J, Hirka G, von Keitz A, Sleijfer DT, Gönczöl E. The surface antigen phenotype of human embryonal carcinoma cells: modulation upon differentiation and viral infection.Recent Results in Cancer Research. Vol. 23. Berlin: Springer-Verlag, 1991:63–83.
- Rodbard D, Bridson W, Rayford PL. Rapid calculation of radio-immunoassay results.J Lab Clin Med 1969;74:770–81.
- Hirata S, Odajima T, Kohama G, Ishigaki S, Niitsu Y. Significance of glutathione S-transferase-π as a tumor marker in patients with oral cancer.Cancer 1992;70:2381–7.
- Altman DG.Practical Statistics for Medical Research. London: Chapman & Hall, 1991.
- Willemse PHB, Sleijfer DT, Schraffordt Koops H, et al. Tumor markers in patients with non-seminomatous germ cell tumors of the testis.Oncodev Biol Med 1981;2:117–28.
- Lange PH, Vogelzang NJ, Goldman A, Kennedy BJ, Fraley EE. Marker half-life analysis as a prognostic tool in testicular cancer.J Urol 1982;128:708–11.
- Kurman RJ, Scardino PT, McIntire KR, Waldmann TA, Javadpour N. Cellular localization of alpha-fetoprotein and human chorionic gonadotropin in germ cell tumors of the testis using an indirect immunoperoxidase technique.Cancer 1977;40:2136–51.
- Wagener C, Menzel B, Breuer H, Weissbach L, Tschubel K, Henkel K, Gedigk P. Immunohistochemical localisation of alpha-fetoprotein (AFP) in germ cell tumours: evidence for AFP production by tissues different from endodermal sinus tumour.Oncology 1981;38:236–9.
- Bartlett NL, Freiha FS, Torti FM. Serum markers in germ cell neoplasms.Hematol Oncol Clin North Am 1991;5:1245–60.
- Milford Ward A. Serum markers in the diagnosis and management of testicular cancer.Adv Biosci 1986;55:123–5.
- Mostofi FK, Sesterhenn IA, Davis CJ. Immunopathology of germ cell tumors of the testis.Semin Diagn Pathol 1987;4:320–41.
- Vugrin D, Friedman A, Whitmore WF. Correlation of serum tumor markers with responses to chemotherapy and surgery.Cancer 1984;53:1440–5.
- Bosl GJ, Geller NL, Cirrincione C, Nisselbaum J, Vugrin D, Whitmore WF, Golbey RB. Serum tumor markers in patients with metastatic germ cell tumors of the testis: a 10-year experience.Am J Med 1983;75:29–35. CrossRef
- Newlands ES, Rustin GJS, Begent RJH, Parker D. Further advances in the management of malignant teratomas of the testis and other sites.Lancet 1983;1:948–51.
- Rorth M, Jacobsen GK, von der Maase H, Madsen EL, Nielsen OS, Pedersen M, Schultz H. Surveillance alone versus radiotherapy after orchiectomy for clinical stage I nonseminomatous testicular cancer.J Clin Oncol 1991;9:1543–8.
- Peckham MJ, Barrett A, Horwich A, Hendry WF. Orchiectomy alone for stage I testicular non-seminoma.Br J Urol 1983;55:754–9.
- Raghavan D, Colls B, Levi J, Fitzharris B, Tattersall MHN, Atkinson C, Woods R, et al. Surveillance for stage I non-seminomatous germ cell tumours of the testis: the optimal protocol has not yet been defined.Br J Urol 1988;61:522–6.
- Bates SE, Longo DL. Use of serum tumor markers in cancer diagnosis and management.Sem Oncol 1987;14:102–38.
- Oosterhuis JW, Suurmeijer AJH, Sleijfer DT, Schraffordt Koops H, Oldhoff J, Fleuren G. Effects of multiple-drug chemotherapy (cis-diammine-dichloro-platinum, bleomycin and vinblastine) on the maturation of retroperitoneal lymph node metastases of non-seminomatous germ cell tumors of the testis: no evidence for de novo induction of differentiation.Cancer 1983;51:408–16.
- Murphy P, Johnson DH. Staging and prognostic factors in non-seminomatous testicular cancer.Hematol Oncol Clin North Am 1991;5:1233–43.
- Klepp O, Olsson AM, Henrikson H, Aass N, Dahl O, Stenwig AE, Persson BE, et al. Prognostic factors in clinical stage I nonseminomatous germ cell tumors of the testis: multivariate analysis of a prospective multicenter study.J Clin Oncol 1990;8:509–18.
- Dunphy CH, Ayala AG, Swanson DA, Ro JY, Logothesis C. Clinical stage I nonseminomatous and mixed germ cell tumors of the testis: a clinicopathologic study of 93 patients on a surveillance protocol after orchiectomy alone.Cancer 1988;62:1202–6.
- Pont J, Höltl W, Kosak D, Machacek E, Kienzer H, Julcher H, Honetz N. Risk-adapted treatment choice in stage I nonseminomatous testicular germ cell cancer by regarding vascular invasion in the primary tumor: a prospective trial.J Clin Oncol 1990;8:16–20.
- Importance of a new tumor market TRA-1-60 in the follow-up of patients with clinical stage I nonseminomatous testicular germ cell tumors
Annals of Surgical Oncology
Volume 4, Issue 4 , pp 321-327
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- Testis cancer
- Nonseminomatous germ cell tumors
- Tumor marker
- Industry Sectors
- Author Affiliations
- 1. Dept. of Surgical Oncology, University Hospital Groningen, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands
- 2. the Department of Immunochemistry, University Hospital Groningen, The Netherlands
- 3. the Department of Medical Oncology, University Hospital Groningen, The Netherlands
- 4. the Department of Health Sciences, Section of Epidemiology and Statistics, University Hospital Groningen, The Netherlands
- 5. the Department of Biomedical Science, University of Sheffield, England