Serum levels of alpha-fetoprotein and human chorionic gonadotropin were used in the management of 50 consecutive patients with non-seminomatous germ cell tumors of the testis. Of the 50 patients 36 had clinical or pathologic documentation of malignancy at some time during their treatment and 34 of these patients (94 per cent) had elevated levels of 1 or both of the markers. The marker(s) was elevated before lymphadenectomy in 9 of 15 patients (60 per cent) with clinical stage A or B disease who had not been cured by orchiectomy. Among patients with pathologic stage B disease elevated marker levels before or after lymphadenectomy were of no prognostic significance. All of the patients with Stage C disease had elevated marker(s) and the effectiveness of chemotherapy in destroying measurable disease generally was reflected in the marker levels.
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