A 35-year-old male presents with a painless right testicular mass. Tumour markers show: AFP 1200 ng/mL (N <10), beta-hCG 3 IU/L (N <5), LDH 2x upper limit of normal. CT shows no retroperitoneal nodes and no visceral metastases. According to IGCCCG risk classification, which prognostic group does this patient belong to?
- A Good prognosis ✓
- B Intermediate prognosis
- C Poor prognosis
- D Cannot be classified without histology
Explanation
For non-seminomatous germ cell tumours, the IGCCCG (International Germ Cell Cancer Collaborative Group) good-prognosis criteria are: testicular/retroperitoneal primary, AFP <1000 ng/mL — however AFP is 1200 here, which crosses into intermediate (AFP 1000-10,000). However, if only AFP is elevated and beta-hCG and LDH remain low-moderate, one should re-evaluate. AFP 1200 and LDH 2x ULN with normal hCG and no non-pulmonary visceral metastases categorises as INTERMEDIATE prognosis (AFP 1000-10000 OR hCG 1000-10000 OR LDH 1.5-10x ULN). The correct answer is B — Intermediate prognosis.
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.