title: [Clinical analysis of primary mediastinal germ cell tumors].
abstract: 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.
authors: Department of Oncology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing 100730, China. phoenixzhou@hotmail.com
authors: Jian-feng
authors: JF
authors: Zhou
authors: Chun-mei
authors: CM
authors: Bai
authors: Di
authors: D
authors: Yang
authors: Shu-chang
authors: SC
authors: Chen
mesh_terms: 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
chemical_list: D043823:Taxoids; D001761:Bleomycin; D005047:Etoposide; D002945:Cisplatin; D007069:Ifosfamide