Capdevila Patricia, Carrasco Cristobal, Gómez Elisa, Escrivá Carlos, Soria Emilio, Esteve Josep M, Aparicio Urtasun Jorge
Department of Medical Oncology, Hospital Universitario y Politécnico La Fe, Avda. Abril Martorell 106, 46016, Valencia, Spain.
Clin Transl Oncol. 2025 Apr 30. doi: 10.1007/s12094-025-03904-2.
Extragonadal germ cell tumors (EGCT) are rare malignancies, typically located in midline structures, with treatment consisting of cisplatin-based chemotherapy. We aimed to evaluate long-term outcomes, identify prognostic factors and assess treatment efficacy.
We retrospectively evaluated 31 patients with EGCT between 1994 and 2024. RStudio was used for data analysis. Progression free survival (PFS) and overall survival (OS) was assessed using Kaplan-Meier, and prognostic factors via Cox regression. Approval was obtained from our local Ethics Committee.
The most common site was mediastinum (59%), followed by retroperitoneum and central nervous system. Non-seminomatous germ cell tumors (NSGCT) were more frequent than seminomas (61% vs. 39%), and 41% of patients had metastasis at diagnosis. After first-line chemotherapy plus selective surgery or irradiation, the disease control rate was 81%. Progression or relapse occurred in 48% of patients, mostly in those with mediastinal NSGCT. No secondary malignancies were detected during follow-up. 5- and 10-year OS were 70%. NSGCT histology and mediastinal location were significantly associated with lower survival, with a 5-year OS of 34% in mediastinal NSGCT.
While cisplatin-based chemotherapy remains effective for EGCT patients, mediastinal NSGCT pose significant challenges, highlighting the need for improved strategies.
性腺外生殖细胞肿瘤（EGCT）是罕见的恶性肿瘤，通常位于中线结构，治疗以顺铂为基础的化疗为主。我们旨在评估长期预后，确定预后因素并评估治疗效果。
我们回顾性评估了1994年至2024年间的31例EGCT患者。使用RStudio进行数据分析。采用Kaplan-Meier法评估无进展生存期（PFS）和总生存期（OS），并通过Cox回归分析预后因素。获得了当地伦理委员会的批准。
最常见的部位是纵隔（59%），其次是腹膜后和中枢神经系统。非精原性生殖细胞肿瘤（NSGCT）比精原细胞瘤更常见（61%对39%），41%的患者在诊断时已有转移。一线化疗加选择性手术或放疗后，疾病控制率为81%。48%的患者出现进展或复发，主要是纵隔NSGCT患者。随访期间未检测到继发性恶性肿瘤。5年和10年总生存率为70%。NSGCT组织学类型和纵隔部位与较低的生存率显著相关，纵隔NSGCT的5年总生存率为34%。
虽然以顺铂为基础的化疗对EGCT患者仍然有效，但纵隔NSGCT带来了重大挑战，凸显了改进治疗策略的必要性。
