Fig. 2

Patient characteristics and Em-EP delivery. a Male GCT patients who received Em-EP (n = 22) mostly presented with IGCCCG intermediate or poor-risk disease. 19/22 male patients (86%) were treated for disease confirmed histologically. Metastatic sites for patients with gonadal primaries (n = 15) included pulmonary only (n = 5, 33%) and non-pulmonary visceral disease (liver, brain and presumed peritoneal disease with ascites; n = 5, 33%). No visceral metastases were present in 5 males (33%) who had symptomatic high-volume lymphadenopathy, which in 2 cases led to bilateral hydronephrosis and renal dysfunction. b Female GCT patients (n = 29) frequently received Em-EP for advanced stage disease. Metastatic sites included pulmonary only (n = 6, 20%) and non-pulmonary visceral disease (liver, brain, bone, bowel and abdominal wall; n = 10, 33%). 13 female patients were free from visceral metastases at their emergency presentation (43%) but presented symptomatically from high-volume primary disease, bulky lymphadenopathy or malignant ascites. c FIGO prognostic score for GTN patients (n = 45). Metastatic sites included pulmonary only (n = 22) and non-pulmonary visceral disease (central nervous system, kidneys, liver, bladder, spleen, colon and thyroid) (n = 8). 15 GTN patients (33%) had no visceral metastases at presentation. d Frequency distribution for Em-EP cycles administered. Multiple weekly cycles were used in patients deemed too unwell, for example due to organ failure, before standard full-dose chemotherapy with either: 2 cycles (n = 16, 15%), 3 cycles (n = 2, 2%), 4 cycles (n = 0, 0.0%) or 5 cycles (n = 1, 1%)