IMPORTANCE OF A NEW TUMOR-MARKER TRA-1-60 IN THE FOLLOW-UP OF PATIENTS WITH CLINICAL STAGE-I NONSEMINOMATOUS TESTICULAR GERM-CELL TUMORS

Background: TRA 1-60 is a new tumor marker for embryonal carcinoma-pos itive nonseminomatous testicular germ cell tumors (NSTGCT). Upper norm al reference value (RV) and serum half-life (t(1/2)) 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 t(1/2). In all pa tients, TRA-1-60 was determined at the time of orchidectomy. In 42 pat ients with recurrence, values were also evaluated 1 month before and a t the time of computed tomography-confirmed recurrence. Predictive val ues and survival probability were examined and compared with values fo r alpha-fetoprotein (AFP) and human chorionic gonadotropin (hCG). Resu lts: RV was 230 U/ml and t(1/2) 9.5 days. Elevated TRA-1-60 at the tim e 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 pati ents 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-f ree 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 T RA-1-60 may improve the early detection of recurrence.