[Staging evaluation and surveillance in tumors of the testicle]

In 1992, the staging and follow-up of testicular germ cell tumours is based on a combination of computed tomography and tumour markers. Due to the development of medical imaging over the last decade, abdominal and thoracic CT has now replaced the combination of lymphography and pulmonary tomographies. Testicular ultrasonography is valuable for the diagnosis and contributes to staging and follow-up. The chest x-ray is still performed and MRI has very exceptional indications. Tumour markers, essentially alpha-foetoprotein and the free beta fraction of human chorionic gonadotrophin, are useful in more than 80% of NSGCTs and about 15% of seminomas (beta-HCG alone). A very high initial level often indicates a poor prognosis. Monitoring of markers is essential after exclusive orchidectomy and to assess the efficacy of chemotherapy.