Radiology, Vol 167, 641-646, Copyright © 1988 by Radiological Society of North America
Failure patterns of nonseminomatous testicular germ cell tumors: radiographic analysis of 51 cases
PC Stomper, MA Socinski, WD Kaplan and MB Garnick
Department of Radiology, Harvard Medical School, Boston, MA.
A retrospective analysis was performed of 51 consecutive cases of treatment
failure (tumor recurrence) of nonseminomatous germ cell tumors. Twelve
patients with clinical stage I disease relapsed after lymph node
dissection; 39 with stage II or III disease relapsed after chemotherapy.
Routine follow-up consisted of monthly chest radiography and determination
of serum tumor marker levels (alpha-fetoprotein and human chorionic
gonadotropin), as well as abdominal computed tomography every 6 months. The
median recurrence interval was 3 months; 96% of the relapses occurred
within 2 years. In 61% of patients, recurrence was in the initial disease
site only, in 26% it was in both new and initial sites, and in 13% it was
in new sites only. At the time of treatment failure, 47 (92%) of the
patients had positive radiologic studies and 44 (86%) had positive serum
marker levels. Nine (18%) had positive radiologic studies only, and four
(8%) had positive serum marker levels only. The analysis demonstrated the
complementary role of radiologic studies and serum tumor-marker assays in
detecting treatment failure.
