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How would you treat a patient with late relapsed metastatic seminoma with only large (>10cm) pulmonary metastases and LDH nine times the upper limit of normal?   

In reviewing the data, LDH does not upstage to intermediate risk but those patients tend to do worse.

Would one treat this patient as intermediate risk, with 4 cycles of VIP (given poor baseline lung function) or would 4 cycles of EP suffice?



Answer from: Medical Oncologist at Community Practice
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Answer from: Medical Oncologist at Academic Institution
Comments
Medical Oncologist at Sediman Cancer Center/University Hospitals of Cleveland Case Medical Center
Thank you so much for your expertise, response, an...
Medical Oncologist at Indiana Univ Simon Cancer Center
Since he had radiotherapy to the RPLN’s, tha...
Medical Oncologist at Sediman Cancer Center/University Hospitals of Cleveland Case Medical Center
Agree completely. Appreciated as always. 
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