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

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21 Scopus citations

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 1 2012

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ASJC Scopus subject areas

  • Oncology
  • Urology

Cite this

Rodney, A. J., Tannir, N. M., Siefker-Radtke, A. O., Liu, P., Walsh, G. L., Millikan, R. E., Swisher, S. G., Tu, S. M., & Pagliaro, L. C. (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, 30(6), 879-885. https://doi.org/10.1016/j.urolonc.2010.08.005