Serum Tumour Markers in Testicular Germ Cell Tumours: Frequencies of Elevated Levels and Extents of Marker Elevation Are Significantly Associated with Clinical Parameters and with Response to Treatment
Table 8
Frequencies of elevated marker levels in patients with metastases (>CS1) at key points of time during treatment.
(a)
all GCT patients (>CS1)
nonseminoma patients (>CS1)
bHCG elevated
AFP elevated
LDH elevated
bHCG elevated
AFP elevated
LDH elevated
n (%)
n (%)
n (%)
n (%)
n (%)
n (%)
(n)
95% CI [%]
95% CI [%]
95% CI [%]
(n)
95% CI [%]
95% CI [%]
95% CI [%]
Time-point 1
141
74 (52.5%)
54 (38.3%)
75 (53.2%)
88
52 (59.1%)
51 (58.0%)
47 (53.4%)
43.9 - 60.9
30.4 - 46.9
44.6 - 61.6
48.1 - 69.3
47.0 - 68.2
42.5 - 64.0
Time-point 2
141
53 (37.6%)
48 (34.0%)
46 (32.6%)
88
42 (47.7%)
46 (52.3%)
28 (31.8%)
29.7 - 46.2
26.4 - 42.6
25.1 - 41.1
37.1 - 58.6
41.4 - 62.9
22.5 - 42.7
p-value
<.0001
0.1088
<.0001
0.0124
0.1655
0.0004
Time-point 3
123
26 (21.1%)
30 (24.4%)
45 (36.6%)
84
24 (28.6%)
29 (34.5%)
30 (35.7%)
14.5 - 29.6
17.3 - 33.1
28.2 - 45.8
19.5 - 39.6
24.7 - 45.8
25.8 - 47.0
p-value
<.0001
<.0001
0.0013
<.0001
<.0001
0.0094
Time-point 4
141
4 (2.8%)
5 (3.5%)
43 (30.5%)
88
4 (4.5%)
4 (4.5%)
30 (34.1%)
0.9 - 7.6
1.3 - 8.5
23.2 - 38.9
1.5 - 11.9
1.5 - 11.9
24.5 - 45.1
p-value
<.0001
<.0001
0.0113
<.0001
<.0001
0.0113
p-value: McNemar test for comparisons of expression rates; all comparisons relate to time-point 1 time-point1: before orchiectomy time-point 2: after orchiectomy time-point 3: after first cycle of chemotherapy (not all patients had chemotherapy) time-point 4: at completion of therapy.
(b) Changes of median marker levels during treatment in all GCT patients with metastases (>CS1)
bHCG [x-fold of ULN]
AFP [x-fold of ULN]
LDH [x-fold of ULN]
N
Min
Median (Q1 - Q3)
Max
Min
Median (Q1 - Q3)
Max
Min
Median (Q1 - Q3)
Max
Time-point 1
141
0.18
1.31 (0.45 - 14.38)
749063.67
0.12
0.59 (0.27 - 3.29)
5906.58
0.03
1.04 (0.88 - 1.42)
17.00
Time-point 2
141
0.03
0.46 (0.41 - 8.59)
357084.27
0.12
0.51 (0.26 - 1.84)
1291.42
0.36
0.89 (0.78 - 1.20)
14.05
Time-point 3
123
0.03
0.45 (0.41 - 0.67)
10728.54
0.10
0.58 (0.36 - 0.97)
2386.53
0.40
0.92 (0.75 - 1.14)
4.68
Time-point 4
141
0.03
0.45 (0.41 - 0.45)
19.13
0.10
0.38 (0.24 - 0.49)
1.78
0.53
0.89 (0.76 - 1.03)
2.17
p-value
<.0001
<.0001
<.0001
p-value: Friedman Test for comparison of marker levels at four time-points; ULN upper limit of norm; Q1 lower quartile; Q3 upper quartile time-point 1: before orchiectomy time-point 2: after orchiectomy time-point 3: after first cycle of chemotherapy, if applicable; not all patients had chemotherapy time-point 4: at completion of therapy.
