Department of Medical Oncology, Tata Medical Center, Kolkata, India.
Department of E.N.T, Medical College, Kolkata, India.
Cancer Rep (Hoboken). 2021 Feb;4(1):e1306. doi: 10.1002/cnr2.1306. Epub 2020 Oct 8.
Malignant mediastinal germ cell tumor (MGCT) is rare and has poor outcomes even after multimodality treatment. Data from resource-poor countries are scarce in the literature.
To evaluate the clinicopathologic features and treatment outcome of primary malignant MGCT at our center.
Single institutional data review of patients aged ≥18 years, treated with a diagnosis of malignant MGCT between Nov'2013 and Nov'2019. Risk stratification was done as per International Germ Cell Cancer Collaborative Group (IGCCCG) classification. Patients were treated with platinum based chemotherapy and surgical resection for the residual disease was performed in non-seminomatous histology.28 patients had MGCT with a median age of 25 years (range:18-36) and all were male. Seven patients had superior vena cava obstruction (SVCO) at diagnosis and pre-treatment histological diagnosis was available in 23 (82%) patients. Seven (25%) patients had seminoma histology, all were of good risk as per IGCCCG risk criteria, whereas others had non-seminoma histology with poor-risk group. Seven patients with seminoma histology achieved a complete response after initial treatment. Six patients with non-seminoma histology underwent complete resection of residual disease post-chemotherapy and five revealed residual viable tumors. After a median follow-up of 10.8 months (range:2.9-75), 3-year progression-free survival (PFS) and overall survival (OS) estimate was 61.2% and 94.7% in the whole cohort, respectively and 3-year PFS and OS estimate was 100% in patients with seminoma histology.
This is the largest data set of MGCT patients' outcomes reported from India with multi-modality treatment. All patients were male and one-fourth had SVCO at presentation. Seminoma histology patients had a 100% outcome after initial platinum based chemotherapy. But, those with non-seminoma histology had a poor outcome even with chemotherapy and surgery.
纵隔生殖细胞恶性肿瘤（MGCT）较为罕见，即使采用多模式治疗，预后仍较差。文献中资源匮乏国家的数据很少。
评估我院原发性恶性 MGCT 的临床病理特征和治疗结果。
对 2013 年 11 月至 2019 年 11 月期间，我院诊断为恶性 MGCT 的年龄≥18 岁患者的单中心数据进行回顾性分析。采用国际生殖细胞癌协作组（IGCCCG）分类进行风险分层。患者接受铂类为基础的化疗，非精原细胞瘤组织学残留病变采用手术切除。28 例患者患有 MGCT，中位年龄为 25 岁（范围：18-36 岁），均为男性。7 例患者初诊时存在上腔静脉阻塞（SVCO），23 例（82%）患者有治疗前的组织学诊断。7 例患者为精原细胞瘤组织学，根据 IGCCCG 风险标准，均为低危，而其他患者为非精原细胞瘤组织学，属于高危组。7 例精原细胞瘤患者在初始治疗后获得完全缓解。6 例非精原细胞瘤患者在化疗后行残余病变完全切除术，5 例患者显示有残余存活肿瘤。中位随访 10.8 个月（范围：2.9-75）后，全队列患者的 3 年无进展生存（PFS）和总生存（OS）估计值分别为 61.2%和 94.7%，而组织学为精原细胞瘤患者的 3 年 PFS 和 OS 估计值为 100%。
这是印度报告的最大的 MGCT 患者多模式治疗结果数据集。所有患者均为男性，四分之一的患者在初诊时存在 SVCO。精原细胞瘤患者在接受初始基于铂类的化疗后，其结果为 100%。但是，即使接受化疗和手术，非精原细胞瘤患者的预后仍较差。
