hCG (Human Chorionic Gonadotropin) Post-Orchiectomy Lab Value
Description
hCG (Human Chorionic Gonadotropin) Post-Orchiectomy Lab Value refers to the lowest hCG value measured post-orchiectomy. hCG 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.
Human chorionic gonadotropin (hCG) is a hormone produced by the placenta and some germ cell tumors. Two subunits, alpha and beta, can be measured in blood or serum. The alpha subunit is a non-specific marker for pancreatic and pituitary tumors. Beta-hCG levels are never found in normal healthy men. When the presence of beta-hCG is detected in serum, it always indicates a malignancy. Beta-hCG is secreted by some non- seminomatous germ cell tumors and mixed tumors and is used with AFP to identify the specific cell type of testicular cancer. Beta-hCG is also useful in monitoring response to therapy. After orchiectomy, the hCG should be undetectable within 5 to 8 days. If elevated hCG persists, this is an indication of residual tumor.
For Testis, there are 4 related data items that record information on hCG.
* 3846: hCG Post-Orchiectomy Lab Value
* 3847: hCG Post-Orchiectomy Range
* 3848: hCG Pre-Orchiectomy Lab Value
* 3849: hCG Pre-Orchiectomy Range
Rationale
hCG (Human Chorionic Gonadotropin) Post-Orchiectomy Lab Value is a Registry Data Collection Variable in AJCC. It was previously collected as Testis CS SSF #14.
Additional Info
**Source documents:** clinical laboratory report (blood or serum test), sometimes in history and physical or clinical statement in pathology report
**Other names include** Human chorionic gonadotropin, b-hCG, beta subunit HCG, beta hCG, -hCG•
For further information, refer to the **Testis** cancer protocol published by the College of American Pathologists for the AJCC Staging System *Testis*
**Normal Reference Range**
* < 2 ng/ml (SI: < 2 µg/L or < 2 ug/L) 1 ng/ml of HCG is approximately 5 mIU/ml.
* < 5 mIU/mL (< 5 IU/L) To record mIU/mL in ng/ml, divide the test result by 5.
**Measurements**
* A lab value expressed in International Units/liter (IU/L) is equivalent to the same value expressed in milli-International Units/milliliter (mIU/mL).
Notes
**Note 1:** **Physician Statement**
* Physician statement of the hCG (Human Chorionic Gonadotropin) Post-Orchiectomy Lab Value can be used to code this data item when no other information is available.
**Note 2:** **Timing**
* Record the value of the hCG test as 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 hCG remains elevated, review subsequent tests and record the lowest hCG 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 3847: hCG Post-Orchiectomy Range.
Coding Guidelines
**1)** **Code XXXXX.9** when
* **a.** The only information available is a statement of elevated or normal
* **b.** If the pre-orchiectomy hCG was normal; a post-orchiectomy hCG may not be performed. In this case, code XXXXX.9 should be recorded.
***Examples***
**1)** 2.0 mIU/mL = Lab Value 2.0, Range 0
**2)** 412 mIU/mL = Lab Value 412.0, Range1
**3)** 6213 mIU/mL = Lab Value 6213.0, Range 2
**4)** 14,724 mIU/mL = Lab Value 14724.0, Range 3
**5)** 108,325 mIU/mL = Lab Value XXXXX.1, Range 3
**6)** Physician states “hCG elevated,” but no value documented = Lab Value XXXXX.9, Range 4
**7)** S value stated (no other information available) = Lab Value XXXXX.9, Range 9
**8)** No hCG test done, or unknown if done = Lab Value XXXXX.9, Range 9
Default
XXXXX.8
Metadata
SSDI
| Code |
Description |
| 0.0 |
0.0 milli-International Units/milliliter (mIU/mL) |
| 0.1-99999.9 |
0.1 - 99,999.9 mIU/mL |
| XXXXX.1 |
100,000 mIU/mL or greater |
| XXXXX.7 |
Test ordered, results not in chart |
| XXXXX.8 |
Not applicable: Information not collected for this case
(If this information is required by your standard setter, use of code XXXXX.8 may result in an edit error.) |
| XXXXX.9 |
Not documented in medical record
No orchiectomy performed
hCG (Human Chorionic Gonadotropin) Post-Orchiectomy Lab Value not assessed or unknown if assessed |
