Objective: To review the utility of tumor markers in the treatment of germ cell testicular tumors.
Methods: The literature on this subject was reviewed.
Results/conclusions: The tumor markers alpha-fetoprotein, beta-HCG and LDH are essential in the management of germ cell tumors. They are useful for the initial diagnosis and postoperatively, particularly in the detection of residual disease following surgery in stage I tumors. Their role as a prognostic marker has been clearly established in the IGCCCG classification. Furthermore, these markers are useful for follow-up, detection of tumor recurrence and for monitoring response to therapy. Spurious increases of marker levels unrelated with tumor progression may occur and should be recognized. The increase in alpha-fetoprotein levels can be caused by liver damage and tumor lysis, and the increase in beta-HCG levels can be caused by hypogonadism, tumor lysis, or may be a discordant increase or hook effect.