SITE SPECIFIC DATA ITEMS (SSDI)/ GRADE

Description

AFP (Alpha Fetoprotein) Post-Orchiectomy Lab Value refers to the lowest AFP value measured post-orchiectomy. AFP is a serum tumor marker that is often elevated in patients with nonseminomatous germ cell tumors of the testis. The Post-Orchiectomy lab value is used to monitor response to therapy. Alpha-fetoprotein (AFP) is a protein normally made by immature liver cells in the fetus. In adults, high AFP levels (> 500 ng/ml) in the blood occur only in hepatocellular carcinoma (>1000), liver metastases (from a primary elsewhere), and germ cell tumors of the testes and ovaries. Elevated AFP values are found in non-seminomatous malignancies and mixed tumors of the testis. AFP is used with HCG to identify the specific cell type of testicular cancer. AFP is not secreted by pure seminoma or teratoma. If AFP > 500 ng/ml, the underlying condition is unlikely to be benign. If AFP > 10,000 ng/ml at diagnosis, the patient is likely to have a poor prognosis. AFP is more useful in monitoring response to therapy than making a diagnosis. The half-life of AFP is 5 to 7 days. After orchiectomy, the AFP should fall to < 25 ng/ml in 25-35 days. If elevated AFP persists, this is an indication of residual tumor. For Testis, there are 4 related data items that record information on AFP for Testis. * 3805: AFP Post-Orchiectomy Lab Value * 3806: AFP Post-Orchiectomy Range * 3807: AFP Pre-Orchiectomy Lab Value * 3808: AFP Pre-Orchiectomy Range

Notes

**Note 1:** **Physician Statement** * Physician statement of the AFP (Alpha Fetoprotein) Post-Orchiectomy Lab Value can be used to code this data item when no other information is available. **Note 2:** **Timing** * Record the lab value of the AFP test results documented in the medical record **after orchiectomy** but prior to adjuvant therapy. The lab value may be documented in a lab report, history and physical, or clinical statement in the pathology report. **Note 3:** **Lab values elevated after orchiectomy** * If the initial post-orchiectomy AFP remains elevated, review subsequent tests and record the lowest AFP value (normalization or plateau) prior to adjuvant therapy or before the value rises again. **Note 4:** **Related data item** * The same laboratory test should be used to record the related data item 3806: AFP Post-Orchiectomy Range.