title: The challenge of poor-prognosis germ cell tumors.
abstract: Patients who have a poor prognosis can be identified at presentation by well-defined prognostic factors. Prognostic groups as defined by the International Germ Cell Consensus Classification should be used in the clinic, in clinical trials, and when reporting results. No systemic treatment has been shown to improve outcome compared with four cycles of chemotherapy composed of bleomycin, etoposide, and cisplatin, which remains the standard of care. Surgery to resect residual masses after chemotherapy and in the salvage setting is a vital component of optimal care. The best outcomes occur with treatment at a center with experience and expertise in their management. Further major improvements are likely to require novel systemic therapies rather than modifications of existing approaches.
authors.affiliation: University of Melbourne, Melbourne, Australia; Department of Medical Oncology, Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia. guy.toner@petermac.org
authors.forename: Guy C
authors.initials: GC
authors.lastname: Toner
mesh_terms: D006801:Humans; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000401:mortality / Q000628:therapy*; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D013736:Testicular Neoplasms / Q000401:mortality / Q000628:therapy*; D016896:Treatment Outcome