In 1976, we began using ultrasound for staging of the retroperitoneal status in patients with testicular cancer. Determinations of tumor markers AFP and Β-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 sonographie 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 sonographie 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 II A; 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 sonographie findings, we got a staging error of 41.7% in the stage IIA. Retroperitoneal lymphadenectomy and histologic analysis of the removed nodes thus remain the only reliable staging system for early nonseminomatous testicular cancer.

Keywords:
Testicular cancer, Staging, Ultrasound, AFP, β-HCG, Retroperitoneal lymphadenectomy
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© 1983 S. Karger AG, Basel
1983
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