IGCCCG Prognostic Group (Metastatic Germ Cell Cancer)

The International Germ Cell Consensus Classification (IGCCCG 1997) for metastatic germ cell cancer.

Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.

Example

Histology
Nonseminoma
NONSEMINOMA ONLY. Primary site; a mediastinal primary is…
Testis or retroperitoneal
Nonpulmonary visceral metastases
No
NONSEMINOMA ONLY. AFP, post-orchiectomy and pre-chemotherapy
2000 ng/mL
NONSEMINOMA ONLY. hCG in IU/L
100 IU/L
NONSEMINOMA ONLY. LDH as a MULTIPLE of the local upper limit…
1 x upper limit of normal

Result: IGCCCG intermediate prognosis, nonseminoma.

The tool opens with these values already filled in. Replace them with your own.

What the result means

Logic
GOOD requires EVERY criterion (AND). Intermediate and poor need ANY ONE marker (OR).
Nonseminoma good
Testis/retroperitoneal, no nonpulmonary visceral mets, AFP <1000, hCG <5000 IU/L, LDH <1.5x normal.
Nonseminoma intermediate
Any of AFP 1000-10000, hCG 5000-50000, LDH 1.5 to under 10x normal.
Nonseminoma poor
Mediastinal primary, OR nonpulmonary visceral mets, OR AFP >10000, hCG >50000, LDH 10x normal or above.
Seminoma
ANY primary site; AFP must be normal; hCG and LDH IGNORED. Good = no nonpulmonary visceral mets; intermediate = present.
No poor seminoma
Seminoma has NO poor-prognosis category. The cell does not exist; never fall through to it.
AFP gate
A raised AFP means the tumor is NOT a pure seminoma and must be classified as nonseminoma.
Units
hCG in IU/L (not IU/mL). LDH as a MULTIPLE of the local upper limit of normal.
Timing
Markers must be POST-orchiectomy and PRE-chemotherapy, or the group is mis-assigned.
Scope
A prognostic group for metastatic disease. Not a diagnosis and not a regimen choice.

What you enter

  • Histology.
  • Nonpulmonary visceral metastases.
  • NONSEMINOMA ONLY.
  • NONSEMINOMA ONLY.
  • NONSEMINOMA ONLY.
  • NONSEMINOMA ONLY.
  • SEMINOMA ONLY.
Full field descriptions
  • Histology. Gates everything else: seminoma ignores hCG and LDH and has no poor category [nonseminoma = Nonseminoma; seminoma = Seminoma (pure, with a normal AFP)]
  • Nonpulmonary visceral metastases. PULMONARY metastases do NOT count for this criterion. In nonseminoma this alone is poor prognosis; in seminoma it alone makes the group intermediate.
  • NONSEMINOMA ONLY. Primary site; a mediastinal primary is poor prognosis on its own. Seminoma permits ANY primary site, so this is not used for seminoma.
  • NONSEMINOMA ONLY. AFP, post-orchiectomy and pre-chemotherapy. Below 1000 good; 1000 to 10000 intermediate; above 10000 poor.
  • NONSEMINOMA ONLY. hCG in IU/L, NOT IU/mL, post-orchiectomy and pre-chemotherapy. Below 5000 good; 5000 to 50000 intermediate; above 50000 poor.
  • NONSEMINOMA ONLY. LDH as a MULTIPLE of the local upper limit of normal, not an absolute value. Below 1.5 good; 1.5 to under 10 intermediate; 10 or above poor.
  • SEMINOMA ONLY. Whether the AFP is normal. This is a GATE, not a graded marker: a raised AFP means the tumor must be classified as a nonseminoma.
How this is calculated

International Germ Cell Cancer Collaborative Group. International Germ Cell Consensus Classification: a prognostic factor-based staging system for metastatic germ cell cancers. J Clin Oncol. 1997;15(2):594-603. Updated outcomes: Gillessen S, et al. J Clin Oncol. 2021;39(14):1563-1574. Read the source ↗

A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.

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Built by Clay Good. Source on GitHub.