A single institution, retrospective study of treatment experience in primary mediastinal germ cell tumors: elucidating the significance of systemic chemotherapy
- Author:
- No author available
- Journal Title:
- Chinese Medical Journal
- Issue:
- 4
- DOI:
- 10.3760/cma.j.issn.0366-6999.2012.04.013
- Key Word:
- germ cell tumors;mediastinal tumors;seminoma,extragonadal;non-seminomatous germ cell tumors;chemotherapy
Abstract： Background Primary malignant germ cell tumors (GCTs) of mediastinum are rare neoplasms.We introduce our institutional experience in managing patients with primary malignant GCTs of the mediastinum,focusing on the analysis of therapeutic modalities.Methods A retrospective review was done in 39 consecutive patients with mediastinal malignant GCTs treated in our institution between 1991 and 2007.Results A total of 39 patients were enrolled in this study with a median age of 27 years.The 5-year overall survival (OS) and progression-free survival (PFS) rates of the whole population were 60.2％ and 57.7％,respectively.Stratified by the histology,18 patients (46.2％) had seminoma and 21 patients (53.8％) had nonseminomatous germ cell tumors (NSGCTs).The 5-year OS rate of patients with seminoma was 87.4％ as compared with 36.7％ in patients with NSGCTs (P=-0.0004).The 5-year PFS rate was also significantly higher in seminoma patients (87.4％ vs.31.6％,P=-0.003).For 19 patients with NSGCTs managed with multi-modality treatment,chemotherapy exposure appeared to impact the prognosis.The 5-year OS rate was 44.9％ in patients with chemotherapy exposure as compared with 20.0％ in patients without it (P=0.43).Conclusion Our study confirmed the significance of systemic chemotherapy in the treatment of primary mediastinal GCTs.
- [1]S D, Williams,R, Birch,L H, Einhorn,etc.Treatment of disseminated germ-cell tumors with cisplatin, bleomycin, and either vinblastine or etoposide.[J].1987,316(23).
- [2]R J, Motzer,G J, Bosl,N L, Geller,etc.Advanced seminoma: the role of chemotherapy and adjunctive surgery.[J].1988,108.
- [3]Shamash J,Powles T,Ansell W,etc.A phase II study using a topoisomerase I-based approach in patients with multiply relapsed germ-cell tumours.[J].2007,18(5).
- [4]K N, Ganjoo,K M, Rieger,K A, Kesler,etc.Results of modern therapy for patients with mediastinal nonseminomatous germ cell tumors.[J].2000,88(5).
- [5]Hisao Asamura,Ryosuke Tsuchiya,Tomoyuki Goya,etc.Malignant germ cell tumor of the mediastinum: A multimodality therapeutic approach[J].1994,24(2).
- [6]P J, Loehrer,R, Birch,S D, Williams,etc.Chemotherapy of metastatic seminoma: the Southeastern Cancer Study Group experience.[J].1987,5.
- [7]C R, Nichols,N A, Heerema,C, Palmer,etc.Klinefelter's syndrome associated with mediastinal germ cell neoplasms.[J].1987,5.
- [8]Horwich Alan,Droz JeanP,Pont Jorg,etc.Extragonadal germ cell tumors of the mediastinum and retroperitoneum: results from an international analysis.[J].2002,20(7).
- [9]Daniel A, Vaena,Rafat, Abonour,Lawrence H, Einhorn.Long-term survival after high-dose salvage chemotherapy for germ cell malignancies with adverse prognostic variables.[J].2003,21.
- [10]Childs WJ,Goldstraw P,Nicholls JE,etc.Primary malignant mediastinal germ cell tumours: improved prognosis with platinum-based chemotherapy and surgery[J].1993.
- [11]Droz JP,Einhorn L,Fossa SD,etc.Second-line chemotherapy in patients with relapsed extragonadal nonseminomatous germ cell tumors: results of an international multicenter analysis.[J].2001,19(6).
- [12]Siegert W,Ballardini M,De Giorgi U,etc.Second-line high-dose chemotherapy in patients with mediastinal and retroperitoneal primary non-seminomatous germ cell tumors: the EBMT experience.[J].2005,16(1).
- [13]R L, Schilsky,S F, Williams,J E, Ultmann,etc.Sequential hydroxyurea-cytarabine chemotherapy for refractory non-Hodgkin's lymphoma.[J].1987,5.
- [14]J D, Hainsworth,D H, Johnson,F A, Greco.The role of cisplatin/bleomycin-based chemotherapy in the treatment of poorly differentiated carcinoma of unknown primary site.[J].1992,19(2 Suppl 5).
- [15]Toner GC,Motzer RJ.Poor prognosis germ cell tumors: current status and future directions.[J].1998,25(2).
- [16]Feldman DR,Turkula S,Fischer P,etc.TI-CE high-dose chemotherapy for patients with previously treated germ cell tumors: results and prognostic factor analysis.[J].2010,28(10).
- [17]Mazumdar M,Motzer RJ,Budnick A,etc.Paclitaxel plus Ifosfamide followed by high-dose carboplatin plus etoposide in previously treated germ cell tumors.[J].2007,25(1).
- [18]C J, Logothetis,M L, Samuels,D E, Selig,etc.Chemotherapy of extragonadal germ cell tumors.[J].1985,3.
- [19]Droz JP,Hartmann JT,Nichols CR,etc.Prognostic variables for response and outcome in patients with extragonadal germ-cell tumors.[J].2002,13(7).