Table 2.

The International Germ Cell Cancer Collaborative Group classification

Histology	Prognostic category	Clinical factors
NSGCT	Good	Testes/retroperitoneal primary AND no non-pulmonary visceral metastases AND good markers (S1) – AFP <1000 ug/ml and – ß-HCG <5000 IU/L and – LDH <1.5 × ULN
	Intermediate	Testes/retroperitoneal primary no non-pulmonary visceral metastases AND intermediate markers (S2) – AFP ≥1000 ng/mL and ≤10 000 ug/mL or – ß-HCG ≥5000 IU/L and ≤50 000 IU/L or – LDH ≥1.5 × ULN and ≤10 × ULN*
	Poor	Mediastinal primary AND/OR non-pulmonary visceral metastases AND/OR any poor marker (S3) – AFP >10 000 ug/mL or – ß-HCG >50 000 IU/L or – LDH >10 × ULN
Seminoma	Good	Any primary site AND no non-pulmonary visceral metastases AND normal AFP, any ß-HCG, any LDH
	Intermediate	Any primary site AND non-pulmonary visceral metastases AND normal AFP, any ß-HCG, any LDH

^*LDH elevation alone for IGCCCG classification is controversial.

AFP: alpha-fetoprotein; ß-HCG: beta human chorionic gonadotrophin; LDH: lactate dehydrogenase; NSGCT: non-seminoma germ cell tumor; ULN: upper limit of normal. Adapted from International Germ Cell Consensus Classification: A prognostic factor-based staging system for metastatic germ cell cancers. International Germ Cell Cancer Collaborative Group.¹⁹