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What is the utility and optimal timing of histologic conformation of NGGCT?
ACNS1123 classified patients as NGGCT if serum & CSF AFP >10 ng/mL or bHCG >100 mIU/ml irrespective of biopsy results & did not mandate biopsy (although surgery was often performed in the setting of radiographic PR/SD/PD when markers normalized).
Do you still need to biopsy at diagnosis if the AFP is >10ng/mL or bHCG is >100mIU/ml, or can you defer unless there are radiographic or marker criteria for diagnostic/oncologic intervention following induction?
Are the present diagnostic thresholds appropriate or should a biopsy always be considered?
Answer from: at Academic Institution
This is a difficult topic and a great question. Unfortunately, the thresholds for tumor marker cut-off values vary internationally for germinoma and NGGCT. The Japanese, who do more aggressive surgeries and have a wealth of experience, use higher cutoff values for germinoma, however, they typically ...
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