Regression Pattern of Alpha Fetoprotein Level Changed after Treatment of Malignant Germ Cell Tumor
Sukumarn Sanersak MD*, Nisa Prueksritanond MD**
Affiliation : * Fellowship in Gynecologic Oncology, Department of Obstetrics and Gynecology Rajavithi Hospital, Bangkok ** Gynecologic Oncologist, Department of Obstetrics and Gynecology Rajavithi Hospital, College of Medicine, Randsit University, Bangkok
Objective : To identify the regression pattern of serum alpha fetoprotein in malignant germ cell tumors after
initial chemotherapy.
Material and Method: This was a retrospective descriptive study. All patients with malignant germ cell tumor
who had elevated serum alpha fetoprotein (AFP) and received adjuvant chemotherapy in Rajavithi Hospital
between January 1984 and May 2007 were included.
Results : Sixty patients with malignant germ cell tumor that met the study criteria were included. The median
progression free interval (PFI) was 64.3 months and the median overall survival (OS) was 70.9 months. Four
courses of chemotherapy was the average. AFP was first negative after a mean of course of three. Two more
cycles were given as a maintenance course. The regression of AFP, between its level before the first and second
courses was less than 0.015, associated with survival, accuracy about 70%, sensitivity 83.3%. The number of
maintenance courses of chemotherapy was statistically affected to PFI and OS (p-value of 0.025, 0.003,
respectively).
Conclusion : The regression of AFP is an independent prognostic factor in malignant germ cell tumor and may
be a useful tool in the therapeutic management of these patients.
Keywords : Progression free interval, Serum alpha fetoprotein, Malignant germ cell tumor
