PRIMARY INTRACRANIAL GERM-CELL TUMORS - A CLINICAL ANALYSIS OF 153 HISTOLOGICALLY VERIFIED CASES

The authors analyzed 153 cases of histologically verified intracranial germ cell tumors. The histological diagnosis was germinoma in 63 pati ents (41.2%), teratoma in 30 (19.6%), and other types of tumors in 60 patients (39.2%). The patients were treated by a consistent policy of surgical removal with histological verification followed by radiation therapy with or without chemotherapy. The 10- and 20-year survival rat es of patients with pure germinoma were 92.7% and 80.6%, respectively. The 10-year survival rates of patients with mature teratoma and malig nant teratoma were 92.9% and 70.7%, respectively. Patients with pure m alignant germ cell tumors (embryonal carcinoma, yolk sac tumor, or cho riocarcinoma) had a 3-year survival rate of 27.3%. The mixed tumors we re divided into three subgroups: 1) mixed germinoma and teratoma; 2) m ixed tumors whose predominant characteristics were germinoma or terato ma combined with some elements of pure malignant tumors; and 3) mixed tumors with predominantly pure malignant elements. The 3-year survival rates were 94.1% for the first group, 70% for the second group, and 9 .3% for the third group, and the differences were statistically signif icant. Twenty-six patients with malignant tumors received chemotherapy that consisted of cisplatin and carboplatin combinations with or with out radiation therapy. However, chemotherapy was not significantly mor e effective than radiation therapy alone. From these treatment results , the authors classified tumors into three groups with different progn oses and proposed a treatment guideline appropriate for the subgroups.