Aparicio J, Montalar J, Munárriz E B, Reynés G, Gómez-Codina J, Pastor M, Herranz C
Department of Medical Oncology, Hospital La Fe, Valencia, Spain.
Eur Urol. 1995;28(1):19-24. doi: 10.1159/000475014.
The records of 23 patients (22 male and 1 female, median age 28 years) with extragonadal germ cell tumors (EGCT) treated between 1974 and 1993 were reviewed retrospectively to investigate long-term survival and prognostic factors. Treatment consisted of cisplatin-based chemotherapy plus local irradiation or surgery. There were 7 seminomas, 5 poorly differentiated carcinomas (PDC) with elevated biomarkers, and 11 nonseminomatous germ cell tumors (NSGCT). The primary sites were retroperitoneum (10 cases), mediastinum (5 cases), pineal gland (4 cases) and other (4 cases). Two partial and 14 complete responses (69.6% overall) were achieved with primary therapy. After a median follow-up of 63 months, 10 (43.5%) patients live disease-free and 5-year survival is 55%. Seminomas showed an excellent outcome. Retroperitoneal NSGCT behaved like testicular neoplasms. Between nonseminoma patients, PDC histology and mediastinal primary were associated with the worst prognoses. EGCT patients should be treated and reported separately according to histology and primary site.
回顾性分析1974年至1993年间接受治疗的23例性腺外生殖细胞肿瘤（EGCT）患者（22例男性，1例女性，中位年龄28岁）的记录，以研究长期生存率和预后因素。治疗包括以顺铂为基础的化疗加局部放疗或手术。其中有7例精原细胞瘤，5例生物标志物升高的低分化癌（PDC），以及11例非精原生殖细胞肿瘤（NSGCT）。原发部位为腹膜后（10例）、纵隔（5例）、松果体（4例）和其他部位（4例）。初始治疗取得了2例部分缓解和14例完全缓解（总体缓解率69.6%）。中位随访63个月后，10例（43.5%）患者无病生存，5年生存率为55%。精原细胞瘤预后良好。腹膜后NSGCT的表现类似于睾丸肿瘤。在非精原细胞瘤患者中，PDC组织学类型和纵隔原发部位的预后最差。EGCT患者应根据组织学类型和原发部位分别进行治疗和报告。
