EXTRAGONADAL GERM-CELL TUMORS - PROGNOSTIC FACTORS AND LONG-TERM FOLLOW-UP

The records of 23 patients (22 male and 1 female, median age 28 years) with extragonadal germ cell tumors (EGCT) treated between 1974 and 19 93 were reviewed retrospectively to investigate long-term survival and prognostic factors. Treatment consisted of cisplatin-based chemothera py plus local irradiation or surgery. There were 7 seminomas, 5 poorly differentiated carcinomas (PDC) with elevated biomarkers, and 11 nons eminomatous germ cell tumors (NSGCT). The primary sites were retroperi toneum (10 cases), mediastinum (5 cases), pineal gland (4 cases) and o ther (4 cases). Two partial and 14 complete responses (69.6% overall) were achieved with primary therapy. After a median follow-up of 63 mon ths, 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. EGC T patients should be treated and reported separately according to hist ology and primary site.