A 35-year-old man is found to have a right testicular mass on ultrasound. Tumor markers: AFP 2300 ng/mL, beta-hCG 15 mIU/mL, LDH 1.2× normal. CT chest shows three pulmonary nodules measuring 1.5 cm each. According to IGCCCG classification, this patient is in which prognostic group?
- A Good prognosis
- B Intermediate prognosis ✓
- C Poor prognosis
- D Cannot be classified without retroperitoneal nodal status
Correct answer: B. Intermediate prognosis
Explanation
The IGCCCG classification for non-seminomatous germ cell tumors: Good prognosis — AFP <1000, hCG <5000, LDH <1.5×N, no non-pulmonary visceral metastases. Intermediate prognosis — AFP 1000–10,000 OR hCG 5000–50,000 OR LDH 1.5–10×N, no non-pulmonary visceral metastases. Poor prognosis — AFP >10,000 OR hCG >50,000 OR LDH >10×N, or non-pulmonary visceral metastases. This patient has AFP 2300 (falls in 1000–10,000 range) with only pulmonary metastases, placing him in intermediate prognosis with 5-year survival approximately 75–80%.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.