title: Clinical Features and Treatment Outcomes in Patients with Extragonadal Germ Cell Tumors: A Single-center Experience.
abstract: BACKGROUND
  The prognosis for non-seminomatous extragonadal germ cell tumors (EGCTs), especially mediastinal, has been shown to be worse than for seminomatous EGCTs.
  
  
  METHODS
  Fourteen patients with EGCT (seven pure seminomas and seven non-seminomas) were treated at the Kanazawa University Hospital between 1992 and 2014; the primary tumor sites were mediastinum in nine patients and retroperitoneum in five patients. All patients were treated with cisplatin-based combination chemotherapeutic regimens followed by a multimodal strategy that included high-dose chemotherapy (HDCT), aggressive surgery, and early salvage chemotherapy.
  
  
  RESULTS
  Although all patients with seminomatous EGCT achieved long-term survival, almost all patients with non-seminomatous EGCT had elevated serum tumor markers and high mortality rates. However, we experienced that patients with mediastinal non-seminomatous EGCT achieved long-term cancer-free survival with HDCT. The 5-year overall survival of patients with seminomatous and non-seminomatous EGCT was 100% and 44%, respectively.
  
  
  CONCLUSIONS
  Herein we describe the treatment outcomes of patients with EGCT at our Institute and propose HDCT reconsideration for poor-risk patients.
authors.affiliation: Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa, Japan mackeeen511@gmail.com.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Makino
authors.affiliation: Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Konaka
authors.affiliation: Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa, Japan.
authors.forename: Mikio
authors.initials: M
authors.lastname: Namiki
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009373:Neoplasms, Germ Cell and Embryonal / Q000401:mortality / Q000628:therapy*; D011379:Prognosis; D012189:Retrospective Studies; D016879:Salvage Therapy; D016019:Survival Analysis; D013736:Testicular Neoplasms / Q000401:mortality / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Extragonadal germ cell tumor; high-dose chemotherapy; salvage therapy