Serum alpha-fetoprotein surge after the initiation of chemotherapy for non-seminomatous testicular cancer has an adverse prognostic significance View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

1998-11

AUTHORS

R de Wit, L Collette, R Sylvester, P H de Mulder, D T Sleijfer, W W ten Bokkel Huinink, S B Kaye, A T van Oosterom, E Boven, G Stoter

ABSTRACT

It has been recognized that the tumour markers alpha-fetoprotein (AFP) and human chorionic gonadotrophin (HCG) may show a transient elevation after the initiation of chemotherapy in non-seminomatous testicular cancer. We investigated the prognostic importance of these so-called marker surges in a cohort of patients treated with cisplatin combination chemotherapy between 1983 and 1991. A total of 669 patients were studied. Of 352 patients who had an elevated AFP at the start of treatment and for whom we had data at both day 1 and day 8, 101 (29%) had a surge. Of 317 patients for whom we had data for HCG, 80 patients (25%) had a surge. It was found that an AFP surge was a strong adverse prognostic factor for progression [hazard ratio (HR) 2.28, P=0.005]. There was no statistically significant difference in survival (HR 1.65, P=0.13). There was no prognostic significance of a HCG surge, either for progression or for survival. To investigate whether a surge was an independent prognostic factor for progression and survival, multivariate Cox regression models were fitted using the independent prognostic factors for progression and survival and the surge/decline variable. An AFP surge was retained in the final model for progression. A HCG surge was of no prognostic importance for progression or survival. We conclude that an AFP surge has an adverse prognostic significance, independent of pretreatment characteristics. More... »

PAGES

1350

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1038/bjc.1998.683

DOI

http://dx.doi.org/10.1038/bjc.1998.683

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1046106295

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/9823978


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