Radiation Oncology/Germ cell/Extragonadal

Extragonadal Germ Cell Tumors

Overview

2-5% of male germ cell tumors are extragonadal.

Treatment

• Multi-institutional; 2002 (1975-96) PMID 11919246 -- "Extragonadal germ cell tumors of the mediastinum and retroperitoneum: results from an international analysis." (Bokemeyer C, J Clin Oncol. 2002 Apr 1;20(7):1864-73.)
  • Retrospective. 635 pts. 11 institutions (US, Europe).
  • 341 pts (54%) primary mediastinal EGCT, 283 (45%) retroperitoneal EGCT. 83% nonseminoma, 16% seminoma. Median age 30 yrs. Treatment was platinum-based chemotherapy.
  • Seminoma: Chemotherapy alone 74%, RT alone 9%, chemo + RT 17%. CR in 65%. Secondary surgical resection in 25 (24%). 5-yr PFS 88% (mediastinal) and 77% (retroperitoneal). OS 88% (both).
  • Non-seminoma (mediastinal): Chemotherapy 98%. RT in <1%. Favorable response (PR or CR with normal tumor markers) in 64%. 49% underwent secondary resection. PFS 44%. OS 45%.
  • Non-seminoma (retroperitoneal): Chemotherapy 98%. RT in <1%. Localized disease in only 24%. Response rate 68%. 45% underwent secondary resection. PFS 45%. OS 62%.
  • Conclusion: Outcome is inferior for pts with nonseminomatous EGCTs.