AFP and neoplasm: A small subset of patients with very high levels of the serum tumor markers (STM) alpha-fetoprotein (AFP), human choriogonadotropin (HCG), and lactate dehydrogenase (LDH), non-pulmonary visceral metastases, and mediastinal extragondal NSGCT have a poor prognosis which influences the choice of chemotherapy regimen and number of cycles.