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Testicular Cancer — SCE Medical Oncology MCQ

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HardUrological CancersTesticular CancerSCE Medical Oncology

A patient with metastatic seminoma has liver metastases, normal AFP and pre-existing fibrotic interstitial lung disease that makes bleomycin unsafe. Renal function is adequate. Which prognosis group and curative regimen are appropriate?

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Correct answer: B — Intermediate prognosis; four cycles of VIP

Seminoma has no IGCCCG poor-prognosis category. Non-pulmonary visceral metastasis places the patient in the intermediate group. Four cycles of BEP are standard, but EAU guidance uses four cycles of VIP when bleomycin is contraindicated, as it is here. EP substitution is a good-risk strategy; single-agent carboplatin and upfront high-dose chemotherapy are not appropriate for this presentation.

Reference: EAU guideline on testicular cancer: disease management (2026 limited update): https://uroweb.org/guidelines/testicular-cancer/chapter/disease-management