All of the following are good prognostic factors for seminoma testis except?
Correct Answer: Nonpulmonary visceral metastases
Description: Ans is 'c' i.e., Nonpulmonary visceral metastasesoPresence of Nonpulmonary visceral metastases is an intermediate prognostic factor. All other are good progsotic factors (see the table below).oAny primary site and any level of tumor markers if present with no nonpulmonary visceral metastasis are considerd good prognostic factors.The International Germ Cell Consensus Classification (IGCCC) prognostic criteria for seminomaGood-prognosis seminoma (90% of seminomas)5-year survival 86%; 5-year progression-free survival (PFS )82%*. Any primary site*. No nonpulmonary visceral metastases*. Normal AFP, any hCG. any LDHIntermediate-prognosis seminoma (10% of seminomas) 5-year survival 72%; 5-year PFS 67%*. Any primary site*. Nonpulmonary visceral metastases*. Normal AFP, any hCG, any LDHPoor prognosis*. No seminoma patients are classified as poor prognosisThe International Germ Cell Consensus Classification (IGCCC) prognostic criteria for seminomaGood-prognosis nonseminoma (56% to 61% of nonseminomas)5-year survival 92%; 5-year progression-free survival (PFS) 89%*. Testis/retroperitoneal primary7*. No nonpulmonary visceral metastases*. Good serum tumor marker levels:-#. Alpha-fetoprotein (AFP) less than 1,000ng/mL#. Human chorionic gonadotropin (hCG) less than 5,000IU/mL (1,000ng/mL)#. Lactate dehydrogenase (LDH) less than 1.5 times the upper limit of normalIntermediate-prognosis nonseminoma (13-28% of nonseminomas)5-year survival 80%; 5-year PFS 75%*. Testis/retroperitoneal primary*. No nonpulmonary visceral metastases*. Intermediate elevation of serum tumor markers#. AFP 1,000 to 10,000ng/mL#. hCG5,000IU/L to 50,000IU/L#. LDH 1.5 to 10 times normalPoor prognosis nonseminoma (16%-26% of nonseminomas)5-year survival 48%; 5-year PFS 41%*. Mediastinal primary*. Nonpulmonary visceral metastases*. Poor serum tumor markers#. AFP more than 10,000ng/mL#. hCG more than 50,000IU/mL (10,000ng/mL)# LDH more than 10 times the upper limit of normal
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