Abstract 322P
Background
The tumour markers alpha-fetoprotein (AFP), beta human chorionic gonadotropin (bHCG), and lactate dehydrogenase (LDH) are essential for diagnosing, managing, and monitoring of testicular cancer. This study assesses the effectiveness of these markers in detecting relapses in seminoma patients.
Methods
This retrospective study analysed data from all testicular seminoma patients treated at our hospital from 2014 to 2022. Baseline characteristics, initial treatments (active surveillance, radiotherapy, chemotherapy), relapse patterns (clinical, radiological, biochemical), stages at relapse and patient survival (those with or without relapse) were documented.
Results
Data from 351 patients were analysed, with a median follow-up of 59 months. The median time to relapse was 12.36 months. Relapse occurred in 46 patients (13.1%), with clinical relapse in 29 patients (63%), radiological relapse in 45 patients (97.8%), and biochemical relapse in 15 patients (32.6%). No isolated biochemical relapse was observed. Locoregional relapses were more common than systemic relapses (65.30% vs. 34.78%). Stages at relapse were predominantly stage II and stage III (58.6% and 39.1%, respectively). AFP levels during relapse ranged from 6 to 20 ng/ml, while bHCG levels ranged from 10 to 6000 mIU/ml. Median overall survival (OS) was 182.3 months for patients without recurrence and 126.73 months for those with recurrence. Table: 322P
Baseline characteristics and recurrence details
| Characteristics | All patients (n = 351) |
| Age | |
| Median | 38 years |
| IQR | 32-47 years |
| Baseline stage | |
| I | 119 (33.9%) |
| II | 110 (31.3%) |
| III | 122 (34.8%) |
| Baseline tumor markers | |
| Elevated AFP or bHCG | 140 (39.9%) |
| Isolated LDH elevation | 171 (48.7%) |
| Normal | 40 (11.4%) |
| Treatment modality | |
| Active surveillance | 48 (13.7%) |
| Chemotherapy | 266 (75.8%) |
| Radiation therapy | 37 (10.5%) |
| Recurrence | (n = 46) |
| Clinical | 29 (63.0%) |
| Radiological | 45 (97.8%) |
| Serological (AFP / BhCG) | 15 (32.6%) |
| Isolated LDH elevation | 1 (2.2%) |
| Stage at recurrence | |
| I | 1 (2.2%) |
| II | 18 (39.1%) |
| III | 27 (58.7%) |
| Treatment at recurrence | |
| Chemotherapy | 36 (78.3%) |
| Radiation therapy | 3 (6.5%) |
| Surgery | 7 (15.2%) |
Conclusions
Our study reaffirms the importance of tumour markers in detecting relapse in testicular seminoma patients, challenging some existing literature.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
D. Samaddar.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.