Vasconcellos VF, et al. - As mainly series from developed nations are considered in reported treatment outcomes for patients with advanced germ cell tumors (aGCT), researchers here reported data from low- and middle-income countries. Performing a retrospective analysis, they distinguished 300 patients (median age: 28 years) with aGCT who were treated at their institution from 2000 to 2015. Based on the International Germ Cell Consensus Classification Group (IGCCCG), they identified 57% with good-, 18.3% intermediate-, and 24.7% poor-risk disease. In IGCCCG good-, intermediate-, and poor-risk groups, median α-fetoprotein levels were 2.9, 243, and 3,998 ng/mL, and those of human chorionic gonadotropin were 0.4, 113, and 301.5 mUI/mL, respectively. They identified reports of 93 progression-free survival (PFS) events and 45 deaths at a median 46 months of follow-up; estimated 5-year PFS and overall survival (OS) were 69% and 85%, respectively, including 83% and 95.3% in good-risk, 70.9% and 83.6% in intermediate-risk, and 35.1% and 62.2% in poor-risk patients, respectively. In multivariable analysis, Eastern Cooperative Oncology Group performance status ≥ 2 was a significant independent prognostic factor for PFS and OS, with a hazard ratio of 2.58 and 6.20, respectively. The analysis revealed similar outcomes among Brazilian patients with aGCT in this cohort vs patients in the IGCCCG database. In comparison with contemporary series, they identified slightly inferior PFS and OS in patients with intermediate- and poor-risk aGCT; this is possibly due to a high percentage of cases with poor performance status and less use of high-dose chemotherapy.