1539P - Primary Mediastinal Germ Cell Tumour in Pakistani Population; a Single Center Experience

Abstract

ABSTRACT Introduction Primary mediastinal germ cell tumor (PMGCT) constitutes a rare malignancy and is a diagnostic challenge because of the difficult approach and often small size of the biopsy specimen. These tumours have a worse prognosis than their gonadal counterparts. This study was performed to review clinical characteristics, therapeutic strategies and outcome of patients with PMGCT at Shaukat Khanum Memorial Cancer Hospital and Research Center Lahore Pakistan. Patient and method Medical records of patients treated in our hospital during 1996 to 2012 were retrospectively studied. Results Of 25 patients, 23 were males with a median age of 23 years (range 16–48). Forty percent were seminoma and 60% were nonseminoma. More than 80% of nonseminoma had raised baseline alpha feto protein. The clinical presentation in order of frequency included; dyspnea (72%), cough (68%), chest pain (56%), pleural/pericardial effusion (44%), weight loss (32%), fever (28%), superior vena-caval obstruction (24%), cervical node metastasis (20%) and pulmonary metastasis (12%). All were treated with initial standard platinum based chemotherapy. Eighty percent of our patients achieved biochemical complete response and 80% achieved radiological response (67% Partial response, 13% complete response). Median survival of patients with seminoma was 37 months with three year survival rate of 60%. Median survival of patients with nonseminoma was 13 months with three year survival rate of 31%. During study period eleven patients died (seven had disease progression, 02 had bleomycin lung toxicity and two had neutropenic sepsis). Conclusion Nonseminoma constitutes the majority of primary mediastinal germ cell tumors, with prominent male preponderance. Seminomas had a better outcome than nonseminomas. Cisplatin based chemotherapy continues to be an effective treatment for these tumours. Disclosure All authors have declared no conflicts of interest.