title: Treatment outcome of patients with extragonadal nonseminomatous germ cell tumors: the Saitama Cancer Center experience.
abstract: BACKGROUND
  Survival of patients with extragonadal nonseminomatous germ cell tumors remains inferior to that of patients with advanced testicular cancer, although treatment is often the same for both conditions. In addition, the prognosis for nonseminomatous tumors has been shown to be worse than for seminoma.
  
  
  METHODS
  Thirteen patients with extragonadal nonseminomatous germ cell tumors were treated between 1998 and 2011; the primary tumors were located in the mediastinum in six and in the retroperitoneum in seven. At initial diagnosis seven patients had distant metastases. According to the IGCCC, eleven patients had poor prognosis and two were intermediate. All 13 patients received cisplatin or carboplatin-based chemotherapy as initial treatment. The patients were further treated by use of a multi-modal strategy which included high-dose chemotherapy, aggressive surgery, and early introduction of salvage regimens.
  
  
  RESULTS
  Complete response was obtained for eight patients. Among these complete responders, one patient remained relapse-free after post-chemotherapy surgical excision of viable cancer tissue. In the course of the chemotherapy, four patients died from cancer progression and one patient died as a result of post-chemotherapeutic sepsis. The other eight patients were alive at the end of the observation period. At the last observation all surviving patients were without evidence of disease. Five-year overall survival for all 13 patients was 62 %, and 5-year cancer-specific survival was 68 %.
  
  
  CONCLUSIONS
  Our results indicate that even patients with far-advanced extragonadal nonseminomatous germ cell tumors can be cured by intensive chemotherapy plus surgery.
authors: Department of Urology, Saitama Cancer Center, 818 Komuro, Ina, Kita Adachi-gun, Saitama, 362-0806, Japan. na-fukui@cancer-c.pref.saitama.jp
authors: Naotaka
authors: N
authors: Fukui
authors: Yusuke
authors: Y
authors: Kohno
authors: Jun-Ichiro
authors: J
authors: Ishioka
authors: Hiroshi
authors: H
authors: Fukuda
authors: Yukio
authors: Y
authors: Kageyama
authors: Yotsuo
authors: Y
authors: Higashi
mesh_terms: D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D044466:Asian People; D016190:Carboplatin / Q000008:administration & dosage / Q000627:therapeutic use; D002945:Cisplatin / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009373:Neoplasms, Germ Cell and Embryonal / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D013736:Testicular Neoplasms; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D016190:Carboplatin; D002945:Cisplatin