Survival Outcomes of Patients With Primary Mediastinal Germ Cell Tumors: A Retrospective Single-institutional Experience

Hiroshi Yaegashi; Takahiro Nohara; Kazuyoshi Shigehara; Kouji Izumi; Yoshifumi Kadono; Tomoyuki Makino; Kaname Yamashita; Koushiro Ohtsubo; Hiroko Ikeda; Atsushi Mizokami

doi:10.21873/cdp.10116

Survival Outcomes of Patients With Primary Mediastinal Germ Cell Tumors: A Retrospective Single-institutional Experience

Cancer Diagn Progn. 2022 May 3;2(3):352-359. doi: 10.21873/cdp.10116. eCollection 2022 May-Jun.

Authors

Affiliations

¹ Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.
² Department of Urology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan.
³ Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Kanazawa, Japan.
⁴ Department of Pathology, Kanazawa University Hospital, Kanazawa, Japan.

Abstract

Background/aim: Primary mediastinal non-seminomatous germ cell tumors (PMNSGCTs) are occasionally complicated by a hematologic malignancy, as with somatic-type malignant tumors called germ cell tumors with somatic-type malignancy (GCTSTM) and are known to have a poor prognosis.

Patients and methods: Data obtained between September 1997 and February 2020 for patients with mediastinal germ cell tumor at our institution were retrospectively analyzed. Key outcome measures included survival rates and the clinical features of non-seminoma cases.

Results: Of 16 patients, 9 had pure seminoma, and 7 had non-seminoma. At the median follow-up of 56.2 months, the 5-year survival rate was significantly higher in patients with seminoma (100%) than in those with non-seminoma (37%) (log-rank test, p=0.0153). Regarding PMNSGCT, two patients evolved into GCTSTM and three had concomitant hematological malignancies.

Conclusion: Patients with PMNSGCTs, GCTSTM complications, and hematologic malignancies showed poor survival, suggesting the need for the development of treatment strategies.

Keywords: International Germ Cell Consensus Classification; Mediastinal germ cell tumor; acute megakaryoblastic leukemia; germ cell tumors with somatic-type malignancy; histiocytic sarcoma.