单中心回顾性研究原发性纵隔生殖细胞肿瘤的治疗经验：阐明全身化疗的意义。

A single institution, retrospective study of treatment experience in primary mediastinal germ cell tumors: elucidating the significance of systemic chemotherapy.

机构信息

Department of Medical Oncology, Fudan University Shanghai Cancer Center, 270 Dong An Road, Shanghai, China.

出版信息

Chin Med J (Engl). 2012 Feb;125(4):626-30.

Abstract

BACKGROUND

Primary malignant germ cell tumors (GCTs) of mediastinum are rare neoplasms. We introduce our institutional experience in managing patients with primary malignant GCTs of the mediastinum, focusing on the analysis of therapeutic modalities.

METHODS

A retrospective review was done in 39 consecutive patients with mediastinal malignant GCTs treated in our institution between 1991 and 2007.

RESULTS

A total of 39 patients were enrolled in this study with a median age of 27 years. The 5-year overall survival (OS) and progression-free survival (PFS) rates of the whole population were 60.2% and 57.7%, respectively. Stratified by the histology, 18 patients (46.2%) had seminoma and 21 patients (53.8%) had nonseminomatous germ cell tumors (NSGCTs). The 5-year OS rate of patients with seminoma was 87.4% as compared with 36.7% in patients with NSGCTs (P = 0.0004). The 5-year PFS rate was also significantly higher in seminoma patients (87.4% vs. 31.6%, P = 0.003). For 19 patients with NSGCTs managed with multi-modality treatment, chemotherapy exposure appeared to impact the prognosis. The 5-year OS rate was 44.9% in patients with chemotherapy exposure as compared with 20.0% in patients without it (P = 0.43).

CONCLUSION

Our study confirmed the significance of systemic chemotherapy in the treatment of primary mediastinal GCTs.

摘要

背景

原发性纵隔生殖细胞肿瘤（GCT）是罕见的肿瘤。我们介绍了我们在管理原发性纵隔恶性 GCT 患者方面的机构经验，重点分析了治疗方式。

方法

对 1991 年至 2007 年在我院治疗的 39 例纵隔恶性 GCT 患者进行回顾性分析。

结果

本研究共纳入 39 例患者，中位年龄为 27 岁。全组患者 5 年总生存率（OS）和无进展生存率（PFS）分别为 60.2%和 57.7%。按组织学分层，18 例（46.2%）为精原细胞瘤，21 例（53.8%）为非精原细胞瘤生殖细胞肿瘤（NSGCT）。精原细胞瘤患者 5 年 OS 率为 87.4%，NSGCT 患者为 36.7%（P=0.0004）。精原细胞瘤患者 5 年 PFS 率也明显较高（87.4%比 31.6%，P=0.003）。19 例 NSGCT 患者采用多模态治疗，化疗暴露似乎影响预后。有化疗暴露的患者 5 年 OS 率为 44.9%，无化疗暴露的患者为 20.0%（P=0.43）。