Extragonadal and poor risk nonseminomatous germ cell tumors: Survival and prognostic features Journal Article
| Authors: | Toner, G. C.; Geller, N. L.; Lin, S. Y.; Bosl, G. J. |
| Article Title: | Extragonadal and poor risk nonseminomatous germ cell tumors: Survival and prognostic features |
| Abstract: | One hundred forty‐nine patients with poor risk nonseminomatous germ cell tumors (NSGCT) treated between 1975 and 1988 were studied. Patients were considered poor risk if they had an extragonadal primary site or testicular NSGCT with low predicted probability of achieving a complete response (CR). Primary sites were the testis (99 patients), retroperitoneum (18 patients), and mediastinum (32 patients). Patients with mediastinal NSGCT had lower human chorionic gonadotropin (HCG) (P < 0.0001) and lactate dehydrogenase (LDH) levels (P < 0.0001), and more frequent yolk sac elements (P = 0.002). CR rates were 38% for mediastinal, 61% for retroperitoneal, and 38% for testicular primary sites. Mediastinal NSGCT patients more frequently required resection of residual malignancy to attain a CR (6 of 12). Mediastinal NSGCT had the worst event‐free survival (P = 0.02). Cox regression analysis identified brain or liver metastases as the most important predictor of event‐free survival in poor risk patients. Retroperitoneal NSGCT often have a poor outcome due to advanced presentation, but the likelihood of a CR to therapy can be predicted using criteria applicable to testicular primary tumors. Therefore, not all retroperitoneal NSGCT are poor risk, and retroperitoneal tumors are probably of occult testicular origin. Mediastinal NSGCT have distinct clinical and pathologic features, do not respond as well to chemotherapy, relapse more frequently, and have the worst survival. The likelihood of a CR cannot be predicted using criteria developed for primary testicular tumors, suggesting that mediastinal primary NSGCT is a distinct clinical entity. Copyright © 1991 American Cancer Society |
| Keywords: | adolescent; adult; survival rate; retrospective studies; major clinical study; cisplatin; liver neoplasms; combined modality therapy; brain neoplasms; carboplatin; testis tumor; testicular neoplasms; remission induction; lactate dehydrogenase; retroperitoneal tumor; neoplasms, germ cell and embryonal; retroperitoneal neoplasms; oxidoreductase; mediastinum tumor; mediastinal neoplasms; non seminomatous germinoma; chorionic gonadotropin; lactic acid; middle age; abdominal neoplasms; prognosis; human; male; priority journal; article; support, non-u.s. gov't; support, u.s. gov't, p.h.s. |
| Journal Title: | Cancer |
| Volume: | 67 |
| Issue: | 8 |
| ISSN: | 0008-543X |
| Publisher: | Wiley Blackwell |
| Date Published: | 1991-04-15 |
| Start Page: | 2049 |
| End Page: | 2057 |
| Language: | English |
| DOI: | 10.1002/1097-0142(19910415)67:8<2049::Aid-cncr2820670807>3.0.Co;2-h |
| PUBMED: | 1848473 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Export Date: 27 September 2019 -- Source: Scopus |
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