英文原文：

 

The classic markers that we base clinical decision-making on are alpha-fetoprotein (AFP) and HCG. The important determinant is the nadir marker. We wait for it to either normalize or to plateau off. We make decisions both in advanced and low-stage disease based on the nadir marker.

 

There are some controversies in treatment of low-stage and high-stage NSGCTs in recent years. How to differentiate the two groups in the clinic and what’s the different choice of therapy strategies? Would you please briefly describe for us? That’s a complex question. We assess for risk， and in both low-stage and advanced disease there are high-risk groups and low-risk groups. We tailor treatment according to their risk.

 

In low-stage disease we will observe many patients， perform surgery or start chemotherapy. In advanced disease， patients receive chemotherapy. Those with advanced and non-seminoma disease receive induction chemotherapy and we proceed based on their response. If there is no response or an incomplete response， they may need second-line chemotherapy， or many patients will require a post-chemotherapy retroperitoneal lymph node dissection.