title: Clinical Characteristics and Treatment Outcomes of Patients with Primary Mediastinal Germ Cell Tumors: 10-Years' Experience at a Single Institution with a Bleomycin-Containing Regimen.
abstract: BACKGROUND
  Cisplatin-based chemotherapy followed by surgical resection of the residual tumor remains the standard of care for patients with mediastinal germ cell tumors (MGCTs). To prevent pulmonary complications, a non-bleomycin-containing regimen is generally preferred. This study aims to review the clinical characteristics and outcomes of these patients.
  
  
  METHODS
  A retrospective chart review was undertaken in patients treated for MGCTs between 2003 and 2013.
  
  
  RESULTS
  A total of 40 patients were enrolled; 7 patients were diagnosed with seminoma, while 33 patients had non-seminoma. 92% of patients received chemotherapy as a first treatment modality: 87% bleomycin, etoposide and cisplatin; 13% etoposide and cisplatin, with an objective response rate of 61.3%. Among these, 44% achieved a complete serological response. 17 patients underwent surgical resection of the residual tumor. No patient suffered from pulmonary complications after surgery. The 5-year overall survival (OS) was 71.4 and 27.3% in seminoma and non-seminoma patients, respectively (p = 0.051). For those who received chemotherapy followed by surgical resection with no viable tumor or only mature teratoma detected, the 5-year OS was 72.7% compared with 20.7% in patients not treated with surgery (p = 0.02).
  
  
  CONCLUSIONS
  Our study confirmed the importance of a multimodality approach with primary chemotherapy followed by surgical resection of the residual tumor. A bleomycin-containing regimen can be safely used in this setting.
authors.affiliation: Holistic Center for Cancer Study and Care (HOCC), Division of Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat-Yai, Thailand.
authors.forename: Arunee
authors.initials: A
authors.lastname: Dechaphunkul
authors.forename: Siwat
authors.initials: S
authors.lastname: Sakdejayont
authors.forename: Chirawadee
authors.initials: C
authors.lastname: Sathitruangsak
authors.forename: Patrapim
authors.initials: P
authors.lastname: Sunpaweravong
mesh_terms: D000293:Adolescent; D000328:Adult; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D001761:Bleomycin / Q000008:administration & dosage*; D003131:Combined Modality Therapy / Q000401:mortality; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008479:Mediastinal Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality*; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000517:prevention & control; D009373:Neoplasms, Germ Cell and Embryonal / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality*; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013785:Thailand / Q000453:epidemiology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000903:Antibiotics, Antineoplastic; D001761:Bleomycin