Zhang Jiaqi, Chen Yeye, Liu Lei, Zhou Mengxin, Huang Cheng, Guo Chao, Li Shanqing
Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, People's Republic of China.
Cancer Manag Res. 2021 Nov 13;13:8527-8534. doi: 10.2147/CMAR.S327342. eCollection 2021.
Given the lack of evidence-supported guidance for therapeutic recommendations of primary mediastinal malignant germ cell tumors (PMMGCTs), our study aimed to investigate the clinicopathological features, treatment strategies, and prognostic factors of PMMGCTs.
We carried out a consecutive retrospective evaluation on a series of patients diagnosed with PMMGCTs in Peking Union Medical College Hospital from January 2000 to August 2020.
A total of 58 patients were eligible, consisting of 51 males and seven females. There were 15 patients with seminomas, 39 with nonseminomatous germ cell tumors (NSGCTs), and four with mixed germ cell tumors (GCTs). The 5-year overall survival was 45%, with a median survival time of 32.37 months. Except for the lost follow-up of seven patients, a univariate analysis of overall survival on the remaining patients showed significant differences in pathological type (mixed GCTs were regarded as NSGCTs) (=0.036), tumor size (>11cm) (=0.006), and other sites metastases (OSM) (=0.001), respectively. Multivariate Cox regression analysis revealed that OSM and surgical resection were independently associated with overall survival in all kinds of PMMGCTs.
OSM was an independent risk factor for patients with PMMGCTs. Surgery was proved to contribute to long-term survival. More in-depth clinical evidence is urgently needed to guide the treatment of PMMGCTs.
鉴于原发性纵隔恶性生殖细胞肿瘤（PMMGCTs）的治疗建议缺乏循证指导，我们的研究旨在调查PMMGCTs的临床病理特征、治疗策略和预后因素。
我们对2000年1月至2020年8月在北京协和医院诊断为PMMGCTs的一系列患者进行了连续的回顾性评估。
共有58例患者符合条件，其中男性51例，女性7例。精原细胞瘤患者15例，非精原细胞性生殖细胞肿瘤（NSGCTs）患者39例，混合性生殖细胞肿瘤（GCTs）患者4例。5年总生存率为45%，中位生存时间为32.37个月。除7例失访患者外，对其余患者的总生存进行单因素分析显示，病理类型（混合性GCTs视为NSGCTs）（=0.036）、肿瘤大小（>11cm）（=0.006）和其他部位转移（OSM）（=0.001）分别存在显著差异。多因素Cox回归分析显示，OSM和手术切除在各类PMMGCTs中均与总生存独立相关。
OSM是PMMGCTs患者的独立危险因素。手术被证明有助于长期生存。迫切需要更深入的临床证据来指导PMMGCTs的治疗。
