Correlation of Serum Tumor Markers and Lymphangiography with Degrees of Nodal Involvement in Surgical Stage II Testis Cancer

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Abstract
Sixty patients underwent serum tumor marker studies (.beta.-subunit of human chorionic gonadotropins and .alpha.-fetoprotein) and pedal lymphangiography before retroperitoneal lymph node dissection. Surgical stage II cases were divided according to tumor, node and metastasis staging. .beta.-Human chorionic gonadotropin and/or .alpha.-fetoprotein was elevated in 9% (1 of 11) of the N1 cases, 36% (5 of 14) of the N2A cases, 50% (13 of 26) of the N2B cases and 89% (8 of 9) of the N3 cases. Lymphangiography was positive or suspicious in 9% (1 of 11) of the N1 cases, 36% (5 of 14) of the N2A cases, 46% (12 of 26) of the N2B cases and 56% (5 of 9) of the N3 cases. Serum tumor markers and lymphangiography combined suggested lymph node metastases in 18% (2 of 11) of the N1 cases, 50% (7 of 14) of the N2A cases, 73% (19 of 26) of the N2B cases and 100% (9 of 9) of the N3 cases. Tumor markers and lymphangiography measurements are equally effective in the diagnosis of retroperitoneal lymph node metastases and that diagnostic accuracy is enhanced significantly by combining these 2 modalities. Retroperitoneal lymph node dissection remains the most reliable staging procedure. Reports on the accuracy of clinical staging should be correlated with subcategories of stage II disease.