EGGCT can arise as retroperitoneal (ret) or mediastinal (med) primary tumours. Although treated like primary gonadal germ cell tumours, their prognosis has been regarded worse. 65 patients (pts) with a median age of 28 years (18–78) treated between 1970 and 1993 at Hannover University Medical School were included into this retrospective analysis. Histology was seminoma (S) in 13 (20%) pts (4 ret; 9 med) and non-seminomatous germ cell tumour (NS) in 52 (80%) pts (26 ret, 24 med). Among pts with NS histology 58% and 60% had elevations of AFP and β-HCG, respectively; 76% of pts had an elevation of serum LDH. 47 pts (71%) had metastases in addition to the extragonadalprimary tumour, (7 bone, 12 liver, 24 lung). Most pts were treated with either chemotherapy (CTX) alone (10 pts) or CTX + surgery (43 pts). 16 pts received additional or definitive radiotherapy. 12 of 13 pts with S (92%) achieved CR or PR; 32 pts with NS (63%) achieved CR orPR M- to initial treatment and 19pts (37%)were failures. After a median follow up of 33 months (12-259) 10 pts with med and 13 with ret EGGCT have relapsed. 3-year overall survival for EGGCT pts with S was 78% versus 58% with NS histology. For NS pts no significant difference in overall survival between med and ret localizations of EGGCT was found. The use of platinum/etoposide/ifosfamide-based initial CTX (22 pts) for NS pts proved to be superior to other combination regimens (35 pts) (2-year survival 76% vs 57%).