Table 6.

Risk factors in seminoma and non-seminoma after failure of cisplatin-based first-line treatment

	Favorable	Unfavorable
Histology	seminoma	non-seminoma
Localization of primary tumor	All except primary mediastinal non-seminoma	Primary mediastinal non-seminoma
Response to first-line chemotherapy	CR/NED or PRm−	PRm+ or SD or PD
Progression-free interval	Three months or more after last chemotherapya	Less than 3 months after last chemotherapy
Metastases at relapse	Lymph-node or pulmonary as only metastatic sites	Extrapulmonary visceral metastasesb
Serum tumor markers at relapse	AFP normal HCG ≤1000 U/l	AFP elevated HCG >1000 U/l
Salvage attempt	First salvage	Second or subsequent salvage

^aPatients with late relapse relapses >2 years have an inferior prognosis.

^bLiver, bone or brain metastases.

CR, complete remission; NED, no evidence of disease after surgery; PRm−, partial remission and negative tumor markers; PRm+, partial remission and positive tumor markers; SD, stable disease; PD, progressive disease; AFP, alpha-fetoprotein; HCG, human chorionic gonadotropin.