Survival outcomes for men with mediastinal germ-cell tumors

The University of Texas M. D. Anderson Cancer Center experience

Alan J. Rodney, Nizar M. Tannir, Arlene O. Siefker-Radtke, Ping Liu, Garrett L. Walsh, Randall E. Millikan, Stephen G. Swisher, Shi Ming Tu, Lance C. Pagliaro

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Objective: Primary mediastinal germ-cell tumors are rare, and the effect of newer drugs and treatment strategies in this disease on overall survival is not known. We retrospectively assessed treatment outcomes at a single institution. Materials and methods: We identified men seen at our institution from 1998 through 2005 for mediastinal germ-cell tumors. Medical records were reviewed for patient characteristics, histology, tumor markers, treatment, and survival outcome. Results: Thirty-four patients met study criteria, of whom 27 had nonseminomatous germ-cell tumor (NSGCT) and 7 had pure seminoma. Eleven patients (41%) with NSGCT were alive at last contact with a median overall survival time of 33.5 months. Among 13 patients with NSGCT referred to us at initial diagnosis, 7 (54%) were alive and recurrence-free at a median follow-up of 56.5 months. Progression-free survival was associated with absence of risk factors (any histology other than endodermal sinus tumor, β-hCG ≥ 1000 mIU/mL, or disease outside the mediastinum). For the patients whose disease progressed (n = 5) or who had been referred to us for salvage treatment (n = 14), the 3-year overall survival from the date of first progression was 23%. Conversely, patients with seminoma did uniformly well with platinum-based chemotherapy; most did not undergo radiation or surgery. Conclusion: Chemotherapy given to maximum effect followed by surgical consolidation resulted in long-term progression-free survival for 54% of patients with mediastinal NSGCT. The number of risk factors present at diagnosis may be associated with survival outcome and should be studied in a larger test group.

Original languageEnglish (US)
Pages (from-to)879-885
Number of pages7
JournalUrologic Oncology: Seminars and Original Investigations
Volume30
Issue number6
DOIs
StatePublished - Nov 2012
Externally publishedYes

Fingerprint

Germ Cell and Embryonal Neoplasms
Survival
Neoplasms
Seminoma
Disease-Free Survival
Histology
Endodermal Sinus Tumor
Drug Therapy
Salvage Therapy
Mediastinum
Tumor Biomarkers
Platinum
Medical Records
Radiation
Recurrence
Nonseminomatous germ cell tumor
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Oncology
  • Urology

Cite this

Survival outcomes for men with mediastinal germ-cell tumors : The University of Texas M. D. Anderson Cancer Center experience. / Rodney, Alan J.; Tannir, Nizar M.; Siefker-Radtke, Arlene O.; Liu, Ping; Walsh, Garrett L.; Millikan, Randall E.; Swisher, Stephen G.; Tu, Shi Ming; Pagliaro, Lance C.

In: Urologic Oncology: Seminars and Original Investigations, Vol. 30, No. 6, 11.2012, p. 879-885.

Research output: Contribution to journalArticle

Rodney, AJ, Tannir, NM, Siefker-Radtke, AO, Liu, P, Walsh, GL, Millikan, RE, Swisher, SG, Tu, SM & Pagliaro, LC 2012, 'Survival outcomes for men with mediastinal germ-cell tumors: The University of Texas M. D. Anderson Cancer Center experience', Urologic Oncology: Seminars and Original Investigations, vol. 30, no. 6, pp. 879-885. https://doi.org/10.1016/j.urolonc.2010.08.005
Rodney, Alan J. ; Tannir, Nizar M. ; Siefker-Radtke, Arlene O. ; Liu, Ping ; Walsh, Garrett L. ; Millikan, Randall E. ; Swisher, Stephen G. ; Tu, Shi Ming ; Pagliaro, Lance C. / Survival outcomes for men with mediastinal germ-cell tumors : The University of Texas M. D. Anderson Cancer Center experience. In: Urologic Oncology: Seminars and Original Investigations. 2012 ; Vol. 30, No. 6. pp. 879-885.
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abstract = "Objective: Primary mediastinal germ-cell tumors are rare, and the effect of newer drugs and treatment strategies in this disease on overall survival is not known. We retrospectively assessed treatment outcomes at a single institution. Materials and methods: We identified men seen at our institution from 1998 through 2005 for mediastinal germ-cell tumors. Medical records were reviewed for patient characteristics, histology, tumor markers, treatment, and survival outcome. Results: Thirty-four patients met study criteria, of whom 27 had nonseminomatous germ-cell tumor (NSGCT) and 7 had pure seminoma. Eleven patients (41{\%}) with NSGCT were alive at last contact with a median overall survival time of 33.5 months. Among 13 patients with NSGCT referred to us at initial diagnosis, 7 (54{\%}) were alive and recurrence-free at a median follow-up of 56.5 months. Progression-free survival was associated with absence of risk factors (any histology other than endodermal sinus tumor, β-hCG ≥ 1000 mIU/mL, or disease outside the mediastinum). For the patients whose disease progressed (n = 5) or who had been referred to us for salvage treatment (n = 14), the 3-year overall survival from the date of first progression was 23{\%}. Conversely, patients with seminoma did uniformly well with platinum-based chemotherapy; most did not undergo radiation or surgery. Conclusion: Chemotherapy given to maximum effect followed by surgical consolidation resulted in long-term progression-free survival for 54{\%} of patients with mediastinal NSGCT. The number of risk factors present at diagnosis may be associated with survival outcome and should be studied in a larger test group.",
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T2 - The University of Texas M. D. Anderson Cancer Center experience

AU - Rodney, Alan J.

AU - Tannir, Nizar M.

AU - Siefker-Radtke, Arlene O.

AU - Liu, Ping

AU - Walsh, Garrett L.

AU - Millikan, Randall E.

AU - Swisher, Stephen G.

AU - Tu, Shi Ming

AU - Pagliaro, Lance C.

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Y1 - 2012/11

N2 - Objective: Primary mediastinal germ-cell tumors are rare, and the effect of newer drugs and treatment strategies in this disease on overall survival is not known. We retrospectively assessed treatment outcomes at a single institution. Materials and methods: We identified men seen at our institution from 1998 through 2005 for mediastinal germ-cell tumors. Medical records were reviewed for patient characteristics, histology, tumor markers, treatment, and survival outcome. Results: Thirty-four patients met study criteria, of whom 27 had nonseminomatous germ-cell tumor (NSGCT) and 7 had pure seminoma. Eleven patients (41%) with NSGCT were alive at last contact with a median overall survival time of 33.5 months. Among 13 patients with NSGCT referred to us at initial diagnosis, 7 (54%) were alive and recurrence-free at a median follow-up of 56.5 months. Progression-free survival was associated with absence of risk factors (any histology other than endodermal sinus tumor, β-hCG ≥ 1000 mIU/mL, or disease outside the mediastinum). For the patients whose disease progressed (n = 5) or who had been referred to us for salvage treatment (n = 14), the 3-year overall survival from the date of first progression was 23%. Conversely, patients with seminoma did uniformly well with platinum-based chemotherapy; most did not undergo radiation or surgery. Conclusion: Chemotherapy given to maximum effect followed by surgical consolidation resulted in long-term progression-free survival for 54% of patients with mediastinal NSGCT. The number of risk factors present at diagnosis may be associated with survival outcome and should be studied in a larger test group.

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