29 cases which contains embryonal carcinoma and/or yolk sac tumor with histopathological details were defined as AFP positive group and 40 cases which were hCG positive regardless of histopathological details as hCG positive group.AFPD was defined as AFP value/(resected testicular weight x (proportion of embryonal carcinoma þ yolk sac tumor)). hCGD was defined as hCG value/resected testicular weight. We analyzed the correlation of AFPD, AFP, hCGD, hCG, more than 50% of embryonal carcinoma, and vascular invasion with TNM staging and cancer specific survival (CSS) using logistic regression analysis and chi-square test.RESULTS: In AFP positive group, 2 of the 29 cases died of cancer (median observation period 48.5 months). The median AFPD was 2.3 (0.02-815). TNM staging was 6 cases for stage 1A, 9 for stage 1B, 3 for stage 1S, 2 for stage 2A, 2 for stage 2B, 4 for stage 3A, 4 for stage 3A, 6 for stage 3B, 3 for stage 3C. There were 14 cases with more than 50% embryonal carcinoma, and vascular invasion was found in 21 cases. On univariate analyses, AFPD showed significant correlation with TNM staging, and CSS (p[0.049, p[0.0001). On multivariable analysis, AFPD were independent predictor of CSS (p[0.0103).In hCG positive group, 2 of the 40 cases died of cancer (median observation period 52.5 months). The median hCGD was 2.52 (0.01-1168). 13 cases of seminoma and 27 cases of nonseminoma. TNM staging was 8 for stage1A, 12 for stage 1B, 6 for stage 1S, 3 for stage 2A, 3 for stage 3A, 4 for stage 3B, 1 for stage 3C. There were 11 cases with more than 50% embryonal carcinoma, and vascular invasion was found in 29 cases. Vascular invasion showed significant correlation with TNM staging in univariate and multivariable analysis (p[0.020, p[0.022). There were no significant factors for CSS.CONCLUSIONS: In the AFP positive group, only AFPD correlated with TNM staging and CSS, and in the hCG positive group, only vascular invasion correlated with TNM staging.
