An easily applicable, clinically based, prognostic classification for germ-cell tumours has been agreed on between all the major clinical trial groups. Germ-cell consensus classification presented in the table below should be used in clinical practice and in the designing and reporting clinical trials to aid international collaboration.
Good Prognosis
Non-Seminoma
Testis/retroperitoneal and No non-pulmonary visceral metastases and Good markers - all of:
- AFP < 1000 ng/ml and
- HCG < 5000 iu/l (1000ng/ml) and
- LDH < 1.5x upper limit of normal
Seminoma
Any primar site and No non-pulmonary visceral metastases and Normal AFP, any HCG, any LDH
Intermediate Prognosis
Non-Seminoma
Testis/retroperitoneal primary and No non-pulmonary visceral metastases and Intermediate markers,And any of:
- AFP > 1000 ng/ml and
- HCG > 5000 iu/l and < 50'000 iu/l
- LDH > 1.5x and < 10x N
Seminoma
Any primar site and No non-pulmonary visceral metastases and Normal AFP, any HCG, any LDH
Poor Prognosis
Non-Seminoma
Mediastinal primary or Non-pulmonary visceral metastases or Poor markersAnd any of:
- AFP > 10'000 ng/ml or
- HCG > 50'000 iu/l (10'000 ng/ml) or
- LDH > 10x upper limit of normal
Seminoma
No patients classified as poor prognosis
Reproduced with permission. ©2008 American Society of Clinical Oncology. All rights reserved. International Germ Cell Cancer Collaborative Group: J Clin Oncol Vol.15 (2), 1997: 594-603.