Cisplatin-based chemotherapy followed by surgery for malignant nonseminomatous germ cell tumor of mediastinum: one institution's experience.
OBJECTIVE
The objective of this study was to evaluate the efficacy and safety of cisplatin-based chemotherapy followed by surgery for patients with a malignant nonseminomatous germ cell tumor (NSGCT) of the mediastinum.


METHODS
Ten patients with malignant NSGCTs received cisplatin-based induction chemotherapy and then underwent surgery. The clinicopathological characteristics of these 10 patients were examined retrospectively.


RESULTS
A partial response to induction chemotherapy was noted in eight patients and no response in two. The induction chemotherapy was tolerated well by all the patients. Each patient underwent complete surgical resection of the residual tumor following chemotherapy. A yolk sac tumor was detected in one patient and malignant teratoma along with a yolk sac tumor in one patient postoperatively. The overall survival of the 10 patients was 67% at 60 months of follow-up. The survival rate at 60 months was poorer for the patients whose resected specimens exhibited the presence of viable cells than for those whose specimens were free of viable cells.


CONCLUSIONS
Postchemotherapy surgical resection of the residual tumor plays an integral role in the management of patients with NSGCT. The presence of viable tumor cells in the resected specimens is associated with poor survival.
Nakamura
Yukio
Y
Department of Surgery, National Hospital Organization, Kinkichuo Chest Medical Center, 1180 Nagasone-cho, Sakai, Osaka 591-8555, Japan. n-yukio@mx5.suisui-w.ne.jp
Matsumura
Akihide
A
Katsura
Hiroshi
H
Sakaguchi
Masahiro
M
Ito
Norimasa
N
Kitahara
Naoto
N
Ose
Naoko
N
Kitaichi
Masanori
M
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage / Q000627:therapeutic use; D002945:Cisplatin / Q000008:administration & dosage / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005047:Etoposide / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008479:Mediastinal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D020360:Neoadjuvant Therapy; D018365:Neoplasm, Residual; D009373:Neoplasms, Germ Cell and Embryonal / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery; D011379:Prognosis; D016019:Survival Analysis
D001761:Bleomycin; D005047:Etoposide; D002945:Cisplatin