[Clinical analysis of primary mediastinal germ cell tumors].
OBJECTIVE
To investigate the clinical and pathological features, optimal treatment and prognostic factor in primary mediastinal germ cell tumors (PMGCT).


METHODS
The clinical presentation, pathological features and therapeutic results of 29 patients with PMGCT were retrospectively analyzed.


RESULTS
All the 29 patients were male with a mean age of 26.1 +/- 9.6 years at diagnosis. All tumors were originated from the anterior mediastinum with a mean diameter of 16.0 +/- 5.2 cm. There were 5 (17.2%) primary mediastinal seminomas (PMSGCT) and 24 (82.8%) primary mediastinal nonseminomas (PMNSGCT) in this series. Dyspnea, cough and chest pain were the most common symptoms. Multimodality treatment consisting of cisplatin-based chemotherapy, surgery and radiotherapy was the principal therapy for PMGCT patients. The median survival of the 24 PMNSGCT patients was 19.0 months with 1-, 2-year survival rate of 65.3% and 28.1%, respectively; whereas the median survival of the 5 PMSGCT patients has not reached but longer with significant differences (P = 0.008). Cox multivariate analysis indicated that limited mediastinal disease at diagnosis (P = 0.004) and the use of cisplatin-based combined chemotherapy (P = 0.005) were independent good prognostic factors of PMNSGCT.


CONCLUSIONS
Primary mediastinal nonseminoma constitutes the most of primary mediastinal germ cell tumors. Cisplatin-based combined chemotherapy may be the most effective for the treatment of primary mediastinal germ cell tumors. The prognosis of primary mediastinal nonseminomas is significantly worse than that of primary mediastinal seminomas, and correlated with the extent of disease and chemotherapy.
Zhou
Jian-feng
JF
Department of Oncology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing 100730, China. phoenixzhou@hotmail.com
Bai
Chun-mei
CM
Yang
Di
D
Chen
Shu-chang
SC
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001761:Bleomycin / Q000627:therapeutic use; D002648:Child; D002945:Cisplatin / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005047:Etoposide / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D007069:Ifosfamide / Q000627:therapeutic use; D008297:Male; D008479:Mediastinal Neoplasms / Q000532:radiotherapy / Q000628:therapy*; D008482:Mediastinum / Q000601:surgery; D008875:Middle Aged; D009373:Neoplasms, Germ Cell and Embryonal / Q000532:radiotherapy / Q000628:therapy*; D012074:Remission Induction; D012189:Retrospective Studies; D018239:Seminoma / Q000532:radiotherapy / Q000628:therapy*; D015996:Survival Rate; D043823:Taxoids / Q000627:therapeutic use; D055815:Young Adult
D043823:Taxoids; D001761:Bleomycin; D005047:Etoposide; D002945:Cisplatin; D007069:Ifosfamide