AFP and neoplasm: The poor-risk NSGCT is defined by the presence of a mediastinal primary tumor, non-pulmonary visceral metastases, or any of the following serum tumor marker elevations: alpha-fetoprotein (AFP) >10,000 ng/mL, human choriogonadotropin (hCG) >50,000 IU/L and/or lactate dehydrogenase (LDH) >10 times the upper limit of normal rely on IGCCCG classification.