The Diagnostic Accuracy of Serum Alpha-Fetoprotein Levels in Follow-up for Recurrence of Sacrococcygeal Teratoma; a Nationwide Review of SCT Cases in the Netherlands.

Autor: van Heurn LJ; Emma Children's Hospital, Amsterdam UMC, University of Amsterdam & Vrije Universiteit Amsterdam, Department of Pediatric Surgery, Amsterdam, the Netherlands. Electronic address: l.j.vanheurn@amsterdamumc.nl., Kremer MEB; Department of Pediatric Surgery, University Medical Centre Maastricht, Maastricht, the Netherlands., de Blaauw I; Department of Pediatric Surgery, Radboud University Medical Center, Amalia Children's Hospital, Nijmegen, the Netherlands., van Baren R; Department of Surgery and Pediatric Surgery, University Medical Center Groningen, Groningen, the Netherlands., van Gemert WG; Department of Pediatric Surgery, University Medical Centre Maastricht, Maastricht, the Netherlands., van Goudoever JB; Department of Pediatrics, Amsterdam UMC, University of Amsterdam, Vrije Universiteit, Emma Children 's Hospital, Amsterdam, the Netherlands., Sloots CEJ; Department of Pediatric Surgery and Intensive Care, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands., Witvliet MJ; Department of Pediatric Surgery, University of Utrecht, Wilhelmina Children's Hospital, UMC Utrecht, Utrecht, the Netherlands., Ernest van Heurn LW; Emma Children's Hospital, Amsterdam UMC, University of Amsterdam & Vrije Universiteit Amsterdam, Department of Pediatric Surgery, Amsterdam, the Netherlands., Derikx JPM; Emma Children's Hospital, Amsterdam UMC, University of Amsterdam & Vrije Universiteit Amsterdam, Department of Pediatric Surgery, Amsterdam, the Netherlands.
Jazyk: angličtina
Zdroj: Journal of pediatric surgery [J Pediatr Surg] 2024 Sep; Vol. 59 (9), pp. 1740-1745. Date of Electronic Publication: 2024 Feb 03.
DOI: 10.1016/j.jpedsurg.2024.01.048
Abstrakt: Background: Serum alpha-fetoprotein (AFP) is often used as tumour marker for recurrent sacrococcygeal teratoma (SCT). We aimed to assess the normal dynamics of serum AFP levels after initial resection and diagnostic accuracy of serum AFP levels the follow-up for recurrence in SCT.
Methods: This retrospective study included 57 patients treated for SCT in the six pediatric surgical centers in the Netherlands from 1980 to 2018.
Main Results: 57 patients were included in the study of whom 19 children developed 20 recurrences at a median of 14.0 months after initial resection. No significant difference was found in serum AFP level dynamics between the recurrence and non-recurrence group after initial resection (p = 0.950). Serum AFP levels did not significantly increase before recurrence (p = 0.106) compared to serum AFP levels of children without recurrence at the same time. However, serum AFP levels did significantly increase in malignant recurrences (n = 7) (p = 0.03) compared to patients without recurrence. A cut-off value of 55 μg/L was found to be predictive for recurrent SCT with an Area Under the Curve (AUC) of 0.636 with sensitivity of 50% and specificity of 100%.
Conclusion: Dynamics of serum AFP levels are not different between patients with and without recurrence after initial resection of SCT. Serum AFP levels are not predictive for mature or immature recurrent SCT and normal AFP levels do not rule out recurrent SCT. However, serum AFP levels exceeding 55 μg/L can indicate recurrent SCT, especially malignant recurrences.
(Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: