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  • Title: [Staging of testicular cancer by ultrasound and tumor markers with special respect to stage I and IIA].
    Author: Behrendt H, Heckemann R, Meyer-Schwickerath M, Hartung R.
    Journal: Urol Int; 1983; 38(5):279-84. PubMed ID: 6195792.
    Abstract:
    In 1976, we began using ultrasound for staging of the retroperitoneal status in patients with testicular cancer. Determinations of tumor markers AFP and beta-HCG were done in all patients. Up to 1981 these investigations were followed by retroperitoneal lymphadenectomy in 148 patients. Ultrasound staging had an over-all accuracy of 79% (n = 117). From 31 incorrect results of sonographic staging there were 29 falsely negative findings in the surgical-pathologic stage IIA with only minimal retroperitoneal disease. Because of this fact the sensitivity of sonographic staging was only 67%, the specificity was 98%. Differentiation between stage I and IIA proved to be very difficult. In this group (stage I and IIA; n = 104) the over-all accuracy was 71%, the sensitivity was only 40%, the specificity was 98%. Adding the results of tumor marker determinations to the sonographic findings, we got a staging error of 41.7% in the stage IIA. Retroperitoneal lymphadenectomy and histologic analysis of the removed nodes thus remains the only reliable staging system for early nonseminomatous testicular cancer.
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