Staging evaluation must include a thorough history and physical examination with particular attention to the contralateral testis. Serum tumor markers should be repeated immediately before RPLND and should include β-hCG, LDH, and AFP. Computed tomography (CT) of the chest, abdomen, and pelvis is the most efficient and cost-effective means of detecting metastatic disease. Magnetic resonance imaging (MRI) is usually reserved for the setting of major vascular involvement to assess patency of the inferior vena cava (IVC) and renal vessels ( Bosl et al, 2000 ).
In 1997 the American Joint Committee on Cancer and Union Internationale Contre le Cancer (UICC) adopted a comprehensive staging system that now includes serum tumor markers (TNMS). Stage I refers to disease confined to the testis, stage II implies retroperitoneal metastases, and stage III disease indicates supradiaphragmatic or visceral metastases. In the TNMS system, vascular or lymphatic invasion in the primary tumor is classified in the T2 category and serum tumor markers are included because of their independent prognostic significance ( AJCC, 1998 ).
Wein: Campbell-Walsh Urology, 9th ed.
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Đọc lại để mổ bn 50 tuổi, tinh hòan P to, beta-HCG máu rất cao.