About this item:

234 Views | 285 Downloads

Author Notes:

Adriana Fonseca, MD, Division of Haematology Oncology, University of Toronto, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario, Canada, M5G 1X8; Twitter: @qzaradri; e-mail: adriana.fonseca@sickkids.ca

Conception and design: Adriana Fonseca, Armando J. Lorenzo, Thomas A. Olson, Marcio H. Malogolowkin, James F. Amatruda, Carlos Rodriguez-Galindo, A. Lindsay Frazier, Furqan Shaikh

Administrative support: Thomas A. Olson

Provision of study materials or patients: Thomas A. Olson, Marcio H. Malogolowkin

Collection and assembly of data: Adriana Fonseca, Mark Krailo, Marcio H. Malogolowkin, Deborah F. Billmire, Furqan Shaikh

Data analysis and interpretation: Adriana Fonseca, Caihong Xia, Armando J. Lorenzo, Mark Krailo, Farzana Pashankar, Marcio H. Malogolowkin, James F. Amatruda, Deborah F. Billmire, Furqan Shaikh

All authors: Manuscript writing; Final approval of manuscript; Accountable for all aspects of the work

Mark Krailo: Consulting or Advisory Role: Merck Sharp & Dohme; Travel, Accommodations, Expenses: Merck Sharp & Dohme

Carlos Rodriguez-Galindo: Honoraria: Novimmune

A. Lindsay Frazier: Consulting or Advisory Role: Decibel Therapeutics

No other potential conflicts of interest were reported.



  • Science & Technology
  • Life Sciences & Biomedicine
  • Oncology
  • RISK

Detection of Relapse by Tumor Markers Versus Imaging in Children and Adolescents With Nongerminomatous Malignant Germ Cell Tumors: A Report From the Children's Oncology Group

Show all authors Show less authors


Journal Title:

Journal of Clinical Oncology


Volume 37, Number 5


, Pages 396-+

Type of Work:

Article | Final Publisher PDF


PURPOSE To investigate relapse detection methods among children and adolescents with nongerminomatous malignant germ cell tumors (MGCTs) and to determine whether tumor markers alone might be sufficient for surveillance. METHODS We retrospectively reviewed all patients enrolled in a phase III, single-arm trial for low-risk and intermediate-risk MGCTs. The method used to detect relapse was assessed based on case report forms, tumor markers, imaging, and pathology reports. Relapses were classified into one of two categories on the basis of whether they were (1) detectable by tumor marker elevation or (2) not detectable by tumor markers. RESULTS A total of 302 patients were enrolled, and 284 patients had complete data for review. Seven patients had normal tumor markers at initial diagnosis, and none experienced a relapse. At a median follow-up of 5.3 years, 48 patients (16.9%) had experienced a relapse. After central review, 47 of 48 relapses (98%) were detected by tumor marker elevation. Of the 47 patients, 16 (33.3%) had abnormal tumor markers with normal/unknown imaging, 31 patients (64.6%) had abnormal tumor markers with abnormal imaging, and one patient (2.1%) had abnormal imaging with unknown marker levels at relapse. CONCLUSION Tumor marker elevation is a highly sensitive method of relapse surveillance, at least among children and adolescents with tumor marker elevation at initial diagnosis. Eliminating exposure to imaging with ionizing radiation may enhance the safety of relapse surveillance in patients treated for MGCT.

Copyright information:

© 2019 American Society of Clinical Oncology. All rights reserved.

Export to EndNote