How do you approach patients with neonatal intrapericardial germ cell tumor, as compared to other patients with mediastinal germ cell tumors?   

Mediastinal GCT outside of the congenital window are considered poor risk, but patients with congenital GCT tend to fare well. How does this affect your approach when deciding on the risk/benefit of adjuvant therapy in the setting of a neonatal tumor resected in full with normalizing markers?