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Risk Factors for Germ-Cells Tumours

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

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

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.

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