Abstract | OBJECTIVE: Primary mediastinal germ-cell tumors are rare, and the effect of newer drugs and treatment strategies in this disease on overall survival is not known. We retrospectively assessed treatment outcomes at a single institution. MATERIALS AND METHODS: We identified men seen at our institution from 1998 through 2005 for mediastinal germ-cell tumors. Medical records were reviewed for patient characteristics, histology, tumor markers, treatment, and survival outcome. RESULTS: Thirty-four patients met study criteria, of whom 27 had nonseminomatous germ-cell tumor (NSGCT) and 7 had pure seminoma. Eleven patients (41%) with NSGCT were alive at last contact with a median overall survival time of 33.5 months. Among 13 patients with NSGCT referred to us at initial diagnosis, 7 (54%) were alive and recurrence-free at a median follow-up of 56.5 months. Progression-free survival was associated with absence of risk factors (any histology other than endodermal sinus tumor, β-hCG > 1000 mIU/mL, or disease outside the mediastinum). For the patients whose disease progressed (n = 5) or who had been referred to us for salvage treatment (n = 14), the 3-year overall survival from the date of first progression was 23%. Conversely, patients with seminoma did uniformly well with platinum-based chemotherapy; most did not undergo radiation or surgery. CONCLUSION:
Chemotherapy given to maximum effect followed by surgical consolidation resulted in long-term progression-free survival for 54% of patients with mediastinal NSGCT. The number of risk factors present at diagnosis may be associated with survival outcome and should be studied in a larger test group.
|
Authors | Alan J Rodney, Nizar M Tannir, Arlene O Siefker-Radtke, Ping Liu, Garrett L Walsh, Randall E Millikan, Stephen G Swisher, Shi-Ming Tu, Lance C Pagliaro |
Journal | Urologic oncology
(Urol Oncol)
2012 Nov-Dec
Vol. 30
Issue 6
Pg. 879-85
ISSN: 1873-2496 [Electronic] United States |
PMID | 20933444
(Publication Type: Journal Article, Research Support, N.I.H., Extramural)
|
Copyright | Copyright © 2012 Elsevier Inc. All rights reserved. |
Topics |
- Adolescent
- Adult
- Antineoplastic Combined Chemotherapy Protocols
(therapeutic use)
- Combined Modality Therapy
- Disease-Free Survival
- Humans
- Kaplan-Meier Estimate
- Male
- Mediastinal Neoplasms
(mortality, pathology, therapy)
- Middle Aged
- Neoplasms, Germ Cell and Embryonal
(mortality, pathology, therapy)
- Texas
- Young Adult
|