Serum alpha fetoprotein surge after the initiation of chemotherapy for non-seminomatous testicular cancer has an adverse prognostic significance
(1998) The British journal of cancer — Vol. 78, n° 10, p. 1350-1355 (1998)
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- 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.
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De Wit, R., Collette, L., Sylvester, R. J., de Mulder, P., Sleijfer, DT., Huinink, WWT., Kaye, SB., van Oosterom, A., Boven, E., & Stoter, G. (1998). Serum alpha fetoprotein surge after the initiation of chemotherapy for non-seminomatous testicular cancer has an adverse prognostic significance. The British journal of cancer, 78(10), 1350-1355. https://hdl.handle.net/2078.5/83788 (Original work published 1998)