Follow-up After Treatment

Source: Childhood Extracranial Germ Cell Tumors Treatment (PDQ®)–Health Professional Version, National Cancer Institute.

Source updated: November 5, 2024 · Captured 2026-09-09.

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The following tests and procedures may be performed at the physician's discretion for monitoring children with extracranial GCTs:

AFP and beta-hCG. Monitor AFP and beta-hCG levels monthly for 6 months (period of highest risk) and then every 3 months, for a total of 2 years (3 years for sacrococcygeal teratoma). A COG trial of patients with low-risk and intermediate-risk GCTs reported the following results:[73][Level of evidence C2]

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Forty-eight patients with elevated tumor markers at diagnosis relapsed during the surveillance phase.

At the time of relapse (after central review), 47 of 48 (98%) relapses were detected by tumor marker elevation.

Imaging tests.

MRI/CT may be performed at the completion of therapy.

Imaging tests.

Guided imaging of the primary site may be performed every 3 months for the first year and every six months for the second year. Seminomas and dysgerminomas may recur later, so the imaging schedule may need to be extended.

Imaging tests.

Chest x-ray annually.

Imaging tests.

When tumor markers are normal at diagnosis, ultrasonography or CT/MRI may be performed every 3 months for 2 years and then annually for 5 years for germinomas.

Dramatic improvements in survival have been achieved for children and adolescents with cancer.[74] Between 1975 and 2020, childhood cancer mortality decreased by more than 50%.[3,74,75] During the period from 2002 to 2010, cancer mortality continued to decrease by 2.4% per year for children and adolescents with gonadal tumors, as compared with the period from 1975 to 1998 (plateauing from 1998 to 2001).[74] Childhood and adolescent cancer survivors require close monitoring because late effects of cancer therapy may persist or develop months or years after treatment. For information about the incidence, type, and monitoring of late effects of childhood and adolescent cancer survivors, see Late Effects of Treatment for Childhood Cancer.

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Preserved source evidence · Not medical advice