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International Germ Cell Cancer Collaborative Group (IGCCCG): International germ cell consensus classification: a prognostic factor-based staging system for metastatic germ cell tumours (GCT).

Risk classificationr Non seminoma Seminoma
Good prognosis

Testicular or retroperitoneal primary tumour
and
No non-pulmonary visceral metastases
and
Post-orchiectomy markers - all of:

  • AFP less than 1000 microgram/L
  • ßhCG less than 5000 International units/L
  • LDH less than 1.5 x upper limit of normal

Any primary site
and
No non-pulmonary visceral metastases
and
Normal AFP, any ßhCG, any LDH

56% of non-seminoma
5 year PFS 89%
5 year OS 92%

90% of seminoma
5 year PFS 82%
5 year OS 86%
Intermediate prognosis

Testicular or retroperitoneal primary tumour
and
No non-pulmonary visceral metastases
and
Post-orchiectomy markers - any of:

  • AFP 1000 to 10 000 microgram/L
  • ßhCG 5000 to 50 000 International units/L
  • LDH 1.5 to 10 x upper limit of normal

Any primary site
and
Non-pulmonary visceral metastases
and
Normal AFP, any ßhCG, any LDH

28% of non-seminoma
5 year PFS 75%
5 year OS 80%

10% of seminoma
5 year PFS 67%
5 year OS 72%

Poor prognosis

Mediastinal primary tumour
or
Non-pulmonary visceral metastases
or
Post-orchiectomy markers -

any of:

  • AFP greater than 10 000 microgram/L
  • ßhCG greater than 50 000 International units/L
  • LDH greater than 10 x upper limit of normal
No patients classified as poor prognosis

16% of non-seminoma
5 year PFS 41%
5 year OS 48%

 
AFP: alpha-fetoprotein
ßhCG: beta human chorionic gonadotrophin
LDH: lactate dehydrogenase

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https://www.eviq.org.au/p/196

14 Oct 2019