The usefulness of testosterone administration in identifying false-positive elevation of serum human chorionic gonadotropin in patients with germ cell tumor

Takizawa, Akitoshi; Kawai, Koji; Kawahara, Takashi; Kojima, Takahiro; Maruyama, Satoru; Shinohara, Nobuo; Akamatsu, Shusuke; Kamba, Tomomi; Nakamura, Toshio; Ukimura, Osamu; Jikuya, Ryosuke; Kishida, Takeshi; Kakimoto, Ken‐ichi; Nishimura, Kazuo; Harabayashi, Toru; Nagamori, Satoshi; Yamashita, Shinichi; Arai, Yoichi; Sawada, Yoshitomo; Sekido, Noritoshi; Kinoshita, Hidefumi; Matsuda, Tadashi; Nakagawa, Tohru; Homma, Yukio; Nishiyama, Hiroyuki

doi:10.1007/s00432-017-2520-5

Cited by 6 publications

(9 citation statements)

References 13 publications

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“…However, it is possible that many of the increased β‐HCG levels were false positive, because the increase was mild. STMs might be false positive; therefore, it is desirable to evaluate them carefully . Elevated serum AFP levels after chemotherapy are a relative contraindication for surgery, because they indicate the presence of persistent active cancer cells, particularly yolk sac tumors.…”

Section: Discussionmentioning

confidence: 99%

“…STMs might be false positive; therefore, it is desirable to evaluate them carefully. 2,3 Elevated serum AFP levels after chemotherapy are a relative contraindication for surgery, because they indicate the presence of persistent active cancer cells, particularly yolk sac tumors. Yolk sac tumors in PLs tend to be associated with the presence of residual cancer cells.…”

Section: Discussionmentioning

confidence: 99%

“…AFP and β‐HCG levels reliably indicate the response of NSGCTs to chemotherapy. However, false positive elevation of β‐HCG has sometimes occurred independently of disease status . When these STM levels normalize after chemotherapy, patients with pulmonary RLs detected by CT can undergo pulmonary resection.…”

Section: Introductionmentioning

confidence: 99%

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Prediction models for the viability of pulmonary metastatic lesions after chemotherapy in nonseminomatous germ cell tumors

et al. 2020

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Objectives To analyze predictors associated with viable cells in pulmonary residual lesions after chemotherapy for metastatic testicular nonseminomatous germ cell tumors and to develop models to prioritize pulmonary resection. Methods Between 2008 and 2017, 40 patients underwent pulmonary metastasectomy after chemotherapy for nonseminomatous germ cell tumors. We evaluated these patients, and 326 pulmonary residual lesions were confirmed using computed tomography and pathological evaluations. Relationships with outcomes were analyzed using logistic regression analyses. Risk prediction models were developed, and predictive probabilities for the risk of viable cells were estimated. Results Histological examinations showed that 73 (22%) pulmonary residual lesions contained viable cells: teratomas, 46 (14%); and cancer cells, 37 (11%). Multivariate analyses showed that the predictors associated with cancer cells in the residual lesions were elevated tumor marker levels, multiregimen chemotherapy, increased tumor size 6 months before surgery and the histological composition of the primary lesion, including yolk sac tumors. Additional predictors associated with teratomas were aspect ratio and histological composition of the primary lesion, including teratomas. Conclusions Intratumoral heterogeneity contributes to nonseminomatous germ cell tumor chemoresistance, and primary lesion site yolk sac tumors and teratomas are associated with greater risks of viable cells. Increased residual lesion size during chemotherapy could also be a predictor. Our simple model can predict the presence of viable cells in residual lesions after chemotherapy, and it might assist in decision‐making and prioritizing pulmonary residual lesion resection.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Prediction models for the viability of pulmonary metastatic lesions after chemotherapy in nonseminomatous germ cell tumors

et al. 2020

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“…Entry criteria were: (1) male patients aged 40-80 years; (2) pathologically proven prostate cancer without distant metastasis; (3) no other active malignant disease; and (4) initiation of LHRH agonist (leuprorelin acetate or goserelin acetate) treatment. Between January 2015 and July 2016, 44 consecutive patients were prospectively enrolled.…”

Section: Methodsmentioning

confidence: 99%

“…Although there are several categories of unexplained low level HCG after male GCT treatment, most cases have no active disease (1). In patients with GCT, treatment (orchiectomy and chemotherapy) can cause hypogonadism, which induces increased level of luteinizing hormone (LH) and HCG production from the pituitary gland (2).…”

Section: Introductionmentioning

confidence: 99%

Supposed pituitary-production of human chorionic Gonadotropin induced by androgen deprivation therapy

et al. 2019

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Introduction: The main cause of slightly elevated human chorionic gonadotropin (HCG) after successful treatment of male germ cell tumors is considered to be pituitary-derived HCG. It is well known that pituitary-derived HCG is frequently detected in postmenopausal women. We evaluated the status of serum HCG in men with elevated gonadotropins, which were induced by androgen deprivation therapy, using commercially available assays. Materials and Methods: We enrolled 44 patients with prostate cancer, who underwent luteinizing-hormone releasing hormone agonist treatment. We measured serum follicle-stimulating hormone (FSH), serum luteinizing hormone (LH), serum total HCG, serum free HCG - β subunit, and urine total HCG 3 times per patient, on the day of treatment initiation, the next day, and 3 months after. Results: On the day after treatment initiation, serum and urine HCG was detected in 61% and 73% of patients, respectively. Markedly strong correlations were observed between serum/urine HCG and FSH/LH. In particular, receiver operating characteristic curve analysis indicated excellent area under the curve (0.977, 95% confidence interval 0.951–1.003)) for serum HCG-detectable LH. At the cutoff value of 21.07 mIU/mL for serum HCG-detectable LH, the sensitivity and specificity were 96.7% and 95.3%, respectively. Serum HCG-β was not detectable at any times in any patients. Conclusions: Suggested pituitary-derived HCG can be frequently detected in patients with elevated gonadotropins, and there is a firm association between HCG detection and gonadotropin levels.

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Surveillance des patients atteints de tumeur germinale du testicule

et al. 2019

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The usefulness of testosterone administration in identifying false-positive elevation of serum human chorionic gonadotropin in patients with germ cell tumor

Abstract: Determining the TAT status of patients was effective in discriminating pituitary hCG production.

Cited by 6 publications

References 13 publications

Prediction models for the viability of pulmonary metastatic lesions after chemotherapy in nonseminomatous germ cell tumors

Prediction models for the viability of pulmonary metastatic lesions after chemotherapy in nonseminomatous germ cell tumors

Supposed pituitary-production of human chorionic Gonadotropin induced by androgen deprivation therapy

Surveillance des patients atteints de tumeur germinale du testicule

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