Radiology, Vol 164, 671-674, Copyright © 1987 by Radiological Society of North America
Stage I nonseminomatous germ cell tumors of the testis: radiologic follow-up after orchidectomy
MP Williams, JE Husband and CW Heron
One hundred and forty-seven patients with clinical stage I nonseminomatous
germ cell tumors of the testis were entered into a follow-up program after
orchidectomy. Follow-up consisted of regular clinical examinations,
estimations of the serum markers beta human chorionic gonadotropin and
alpha-fetoprotein, chest radiography, follow- up lymphangiography, and
computed tomography (CT) of the chest and abdomen. The criteria for the
diagnosis of recurrence of disease were (a) a single abnormal node with
elevated serum markers or positive cytologic aspirate, (b) a single
enlarging node on serial studies in the absence of elevated markers, (c)
multiple abnormal nodes, or (d) persistently elevated serum markers without
abnormal radiologic findings. Thirty-seven patients experienced recurrence,
32 (86%) within the 1st year. Disease recurred most often in the abdomen
alone (38%). CT scanning (76%) and marker estimations (68%) enabled
detection of recurrent disease more often than chest radiography (22%) or
lymphangiographic follow-up (13%). A strategy for follow-up based on these
results is outlined.
