Abstract
Purpose: Primary mediastinal germ cell tumors (PMGCTs) are rare. The natural history and optimal treatment strategies still need to be defined. The aim of the study was to summarize the clinical characteristics, treatment outcomes, and prognostic factors of PMGCTs.Methods: Twenty-four patients with PMGCTs who were treated from December 2008 to January 2019 were evaluated retrospectively. The Kaplan–Meier method and Cox regression analysis were used to evaluate factors associated with prognosis.Results: The study population consisted of 23 male patients and 1 female patient. Five patients were diagnosed with seminoma and 19 patients were diagnosed with nonseminoma. The median follow-up time for all patients was 15.8 (3.9–114.5) months. The 5-year overall survival (OS) and progression free survival (PFS) rates for all patients were 65.2 and 44.3%. For nonseminoma and seminoma, the 5-year OS rates were 54.1 and 100% (P = 0.093), respectively, and the 5-year PFS rates were 28.7 and 100%, respectively (P = 0.044). In patients with nonseminoma, first-line radiotherapy indicated superior OS and PFS (P = 0.037 and 0.027, respectively). The median survival time after recurrence was 4.3 months and the 1-year survival rate after recurrence was 23.4%.Conclusion: These results indicated that in PMGCTs, the prognosis of seminoma is superior to that of nonseminoma. Radiotherapy may be an essential treatment in patients with nonseminoma. Patients with relapse have unfavorable prognosis.
Highlights
Only 2–5% of germ cell tumors (GCTs) are primary extragonadal germ cell malignancies, which are predominantly found in mediastinum and retroperitoneum [1]
Pure seminoma was identified in 5 patients and 19 patients were diagnosed as nonseminoma
In the univariate analysis of prognostic factors for overall survival (OS) of nonseminoma, a protracted trend of OS was shown in patients with the greatest dimension of tumor
Summary
More than 90% of germ cell tumors (GCTs) originate from the testis. Only 2–5% of GCTs are primary extragonadal germ cell malignancies, which are predominantly found in mediastinum and retroperitoneum [1]. Their histologies are identical with their testicular counterparts and can be divided into seminoma and nonseminoma [2]. Characteristics and Outcomes of PMGCTs. The genesis of extragonadal germ cell tumors (EGCTs) is still unknown. One proposes that germ cell precursors migrate improperly and survive in ectopic locations. The second believes that the tumors develop from germ cells that are widely distributed during embryogenesis [3, 4]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
