Would you offer salvage chemotherapy to a patient with stage IIIC poor risk NSGCT in whom AFP fail to normalize even after 2 months of completion of 4 cycles BEP?

It depends on the absolute value and the trend of elevated AFP. Low level AFP elevation (usually in the teens) is common and difficult to accurately interpret the abnormality. If the AFP is not rising, I probably proceed to post-chemo RPLND as the first step. Also, sometimes people proceed to chemot...