MRC 1993 Prognostic Factors for Metastatic Non-Seminomatous Testicular Germ Cell Tumors

Description

A retrospective study performed by the British Medical Research Council (MRC) in 795 patients with metastatic non-seminomatous testicular germ cell tumors treated between 1982 and 1986 identified factors for identifying good and poor prognostic groups. These patients were treated with improved chemotherapy regimens compared to that in the previous MRC study reported in 1985.

Prognostic factors identified:

(1) sites of metastases

(2) serum AFP and HCG levels

(3) size of mediastinal metastasis

(4) number of lung metastases

Parameter	Finding	Points
metastases	not to liver, bone or brain	0
	to liver, bone or brain	1
AFP or HCG	AFP < 1,000 kU/L, AND HCG < 10,000 IU/L	0
	AFP >= 1,000 kU/L, OR HCG >= 10,000 IU/L	1
size of mediastinal metastasis	none, or <= 5 cm	0
	> 5 cm	1
lung metastases	none, or < 20	0
	>= 20	1

where

• AFP values seem to be reported in "kU/L" in England. I have been unable to find the factors to convert to ng/mL or µg/L. Stoter et al in Eur Urol 1993; 23: 202-206 (paper immediately following) report similar findings with serum AFP levels reported in "IU/L".

number of adverse prognostic indicators =

= SUM(points present)

Interpretation:

• minimum score: 0

• maximum score: 4

• good prognostic group: score = 0

• poor prognostic group: score >= 1

Score	Prognostic Group	3 Year Survival
0	good	93%
>= 1	poor	68%

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Description

Specialty

ICD-10