Serum tumour markers in testicular and extragonadal germ cell malignancies

Serum tumour marker analyses are now an integral part of the modern management of patients with testicular or extragonadal germ cell tumours of the testis. AFP, HCG and may help in the diagnosis of extragonadal germ cell tumours in (young) males with malignancies of uncertain origin. AFP and HCG analyses play decisive roles in the classification, staging, choice of therapy and monitoring of treatment and follow-up of patients with nonseminomatous germ cell tumours. HCG, LDH and possibly NSE analyses are becoming important tools for the management of advanced seminoma, but there is a need for more reliable markers in this tumour type. Serum samples for AFP and HCG should be obtained before orchiectomy in any patient with a testicular tumour, as the pre-orchiectomy titres may represent important information for the subsequent clinical decision making. Cost-benefit estimates regarding the role of serum tumour markers in saving the life of patients with testis cancer are presented.