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Treatment Option Overview

    continued...

    Intermediate Prognosis

    Nonseminoma:

    • Testis/retroperitoneal primary, and
    • No nonpulmonary visceral metastases, and
    • Intermediate markers–any of:
      • AFP 1,000 ng/mL or more and 10,000 ng/mL or less, or
      • hCG 5,000 IU/L or more and 50,000 IU/L or less, or
      • LDH 1.5 or more × N* and less than 10 × N*

      13%–28% of nonseminomas

      5-year PFS is 75%; 5-year survival is 80%–83%

      *N indicates the upper limit of normal for the LDH assay.

    Seminoma:

    • Any primary site, and
    • Nonpulmonary visceral metastases, and
    • Normal AFP, any hCG, any LDH

      10% of seminomas

      5-year PFS is 67%; 5-year survival is 72%

    Poor Prognosis

    Nonseminoma:

    • Mediastinal primary, or
    • Nonpulmonary visceral metastases, or
    • For markers–any of:
      • AFP more than 10,000 ng/mL, or
      • hCG more than 50,000 IU/mL (10,000 ng/mL), or
      • LDH more than 10 × the upper limit of normal

      16%–26% of nonseminomas

      5-year PFS is 41%; 5-year survival is 71%

    Seminoma:

    • No patients are classified as poor prognosis.

    References:

    1. International Germ Cell Consensus Classification: a prognostic factor-based staging system for metastatic germ cell cancers. International Germ Cell Cancer Collaborative Group. J Clin Oncol 15 (2): 594-603, 1997.
    2. van Dijk MR, Steyerberg EW, Habbema JD: Survival of non-seminomatous germ cell cancer patients according to the IGCC classification: An update based on meta-analysis. Eur J Cancer 42 (7): 820-6, 2006.

    This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http:// cancer .gov or call 1-800-4-CANCER.

    WebMD Public Information from the National Cancer Institute

    Last Updated: February 25, 2014
    This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
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