Turner White CommunicationsAbout TWCSubscribeContact TWCHomeSearch
Hospital PhysicianJCOMSMPBRMsCart
Current Contents
Past Issue Archives
Self-Assessment Questions
Review of
Clinical Signs
Clinical Review
Pediatric Rounds
Resident Grand Rounds
Article Archives
Case Reports
Clinical Practice
Pediatric Rounds
Resident Grand Rounds
Review of
Clinical Signs

Guide to Reading
Hospital Physician
Editorial Board
Information for Authors

Reprints, Permissions, & Copyright
Site Map
Self-Assessment Questions


Answer 1
  1. Poor risk. Risk assessment for patients with testicular tumors is extremely important and can help predict prognosis. The International Germ Cell Consensus risk designation is based on serum tumor marker levels (S stage) and the presence or absence of nonpulmonary visceral metastases.1,2 For nonseminomatous germ cell tumors, presence of a gonadal or retroperitoneal primary tumor with an AFP less than 1000 ng/mL, ßHCG less than 500 mIU/mL, LDH less than 1.5 times normal, and absence of nonpulmonary visceral metastases is considered good-risk disease. A similar tumor location with an AFP 1000 to 10,000 ng/mL, ßHCG 5000 to 50,000 mIU/mL, LDH 1.5 to 10 times normal, and absence of nonpulmonary visceral metastases is considered intermediate-risk disease. The presence of a mediastinal primary tumor, AFP greater than 10,000 ng/mL, ßHCG greater than 50,000 mIU/mL, and LDH greater than 10 times upper limit of normal with the presence of nonpulmonary visceral metastases is considered poor-risk disease.

    1. International Germ Cell Consensus Classification: a prognostic factor-based staging system for metastatic germ cell cancers. International Germ Cell Cancer Collaborative Group. J Clin Oncol 1997;15:594-603.

    2. Bosl GJ, Bajorin DF, Sheinfeld J, et al. Cancer of the testis. In: DeVita VT Jr, Hellman S, Rosenberg SA, editors. Cancer principles & practice of oncology. 6th ed. Philadelphia: Lippincott Williams and Wilkins; 2001:1491-518.

Click here to return to the questions


Hospital Physician     JCOM     Seminars in Medical Practice
Hospital Physician Board Review Manuals
About TWC    Subscribe    Contact TWC    Home    Search   Site Map

Copyright © 2009, Turner White Communications
Updated 1/04/08 • kkj