Department of Medical Oncology, Dr, B.R.A. IRCH, All India Institute of Medical Sciences, New Delhi, India.
Department of Pathology, All India Institute of Medical Sciences, New Delhi, India.
Cancer Invest. 2023 May;41(5):467-473. doi: 10.1080/07357907.2023.2188947. Epub 2023 Mar 30.
Primary mediastinal GCT (PMGCT) is a rare entity and comprises 10-15% of all mediastinal tumors. We present our institutional experience of MGCT treated with multimodality management.
We conducted a retrospective analysis between 2010 to 2020 of all mediastinal germ cell tumors registered at our center. Data on patient demographics, treatments received, treatment toxicities and response were recorded. Overall survival and relapse free survival were estimated using Kaplan-Meier methods.
A total of 30 patients were identified. The median age was 25.5 (range, 18-45) years. Common presenting features included cough (70%) and shortness of breath (70%). Histology wise, 60% patients were non seminomatous histology, whereas 33.3% patients were Seminoma. Twenty-seven (90%) patients received chemotherapy as the first-line treatment, of whom five patients (16.6%) underwent surgery and radiation therapy subsequently. Median follow-up was 26.9 months. Thirteen patients (43.3%) had complete response (43.3%) and eight patients had partial response (26.7%), while three patients (5.5%) had progressive disease. Three-year relapse-free survival rate was 69.6% (95% confidence interval [CI], 42.8-85.6%). Overall survival (OS) at 3 years was 73.4% (95% CI, 49.4-87.3%). Patients with seminoma had a 3 year OS of 90.0% (95% CI, 47.3-98.5%) compared to those with non-seminoma (63.53% [95% CI, 32.3-83.3%]).
Multiagent chemotherapy is the backbone of treatment in PMGCT. Seminomatous PMGCT have excellent prognosis, while further improvement is needed in those with nonseminomatous tumor.
原发性纵隔生殖细胞肿瘤（PMGCT）是一种罕见的实体瘤，占所有纵隔肿瘤的 10-15%。我们介绍了我们机构采用多模式管理治疗 MGCT 的经验。
我们对 2010 年至 2020 年在我们中心登记的所有纵隔生殖细胞肿瘤患者进行了回顾性分析。记录了患者人口统计学、接受的治疗、治疗毒性和反应的数据。使用 Kaplan-Meier 方法估计总生存率和无复发生存率。
共确定了 30 名患者。中位年龄为 25.5 岁（范围 18-45 岁）。常见的表现特征包括咳嗽（70%）和呼吸急促（70%）。组织学上，60%的患者为非精原细胞瘤组织学，33.3%的患者为精原细胞瘤。27 名（90%）患者接受化疗作为一线治疗，其中 5 名（16.6%）随后接受手术和放疗。中位随访时间为 26.9 个月。13 名患者（43.3%）完全缓解（43.3%），8 名患者部分缓解（26.7%），3 名患者疾病进展（5.5%）。3 年无复发生存率为 69.6%（95%置信区间 [CI]，42.8-85.6%）。3 年总生存率（OS）为 73.4%（95%CI，49.4-87.3%）。精原细胞瘤患者 3 年 OS 为 90.0%（95%CI，47.3-98.5%），而非精原细胞瘤患者为 63.53%（95%CI，32.3-83.3%）。
多药化疗是 PMGCT 治疗的基础。精原细胞瘤 PMGCT 预后良好，而非精原细胞瘤肿瘤患者需要进一步改善。
