Patients with advanced, metastatic disease (stage IIC-III) undergo risk stratification according to International Germ Cell Consensus Classification (IGCCC), which considers tumor site (mediastinal vs. others), presence of non-pulmonary visceral metastases as well as the serum tumor markers levels: alpha-fetoprotein (AFP), βhuman chorionic gonadotropin (βhCG) and lactic dehydrogenase (LDH) [4]⁠. This evidence concerns the gene AFP and neoplasm.