A 55-year-old man presents with a painless right testicular mass. Serum AFP is 12,000 ng/mL, beta-hCG is 800 mIU/mL, and LDH is 4x upper limit of normal. CT shows multiple bilateral pulmonary nodules (largest 3 cm) and retroperitoneal lymphadenopathy. Per IGCCCG (International Germ Cell Cancer Collaborative Group) classification, this is:
- A Poor prognosis ✓
- B Good prognosis
- C Intermediate prognosis
- D Stage IIB — intermediate risk
Correct answer: A. Poor prognosis
Explanation
IGCCCG poor-prognosis non-seminoma criteria include: AFP >10,000 ng/mL, beta-hCG >50,000 mIU/mL, or LDH >10x ULN, OR non-pulmonary visceral metastases. This patient has AFP 12,000 (>10,000) placing him in poor prognosis. The 5-year survival for poor prognosis non-seminoma is approximately 48%. Treatment is BEP (bleomycin, etoposide, cisplatin) chemotherapy.
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.