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Cisplatin-based chemotherapy followed by surgery for malignant nonseminomatous germ cell tumor of mediastinum: one institution’s experience

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Abstract

Objective

The objective of this study was to evaluate the efficacy and safety of cisplatin-based chemotherapy followed by surgery for patients with a malignant nonseminomatous germ cell tumor (NSGCT) of the mediastinum.

Methods

Ten patients with malignant NSGCTs received cisplatin-based induction chemotherapy and then underwent surgery. The clinicopathological characteristics of these 10 patients were examined retrospectively.

Results

A partial response to induction chemotherapy was noted in eight patients and no response in two. The induction chemotherapy was tolerated well by all the patients. Each patient underwent complete surgical resection of the residual tumor following chemotherapy. A yolk sac tumor was detected in one patient and malignant teratoma along with a yolk sac tumor in one patient postoperatively. The overall survival of the 10 patients was 67% at 60 months of follow-up. The survival rate at 60 months was poorer for the patients whose resected specimens exhibited the presence of viable cells than for those whose specimens were free of viable cells.

Conclusion

Postchemotherapy surgical resection of the residual tumor plays an integral role in the management of patients with NSGCT. The presence of viable tumor cells in the resected specimens is associated with poor survival.

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References

  1. Kay PH, Wells FC, Goldstraw P. A multidisciplinary approach to primary nonseminomatous germ cell tumors of the mediastinum. Ann Thorac Surg 1987;44:578–582.

    PubMed  CAS  Google Scholar 

  2. Cox JD. Primary malignant germinal tumors of the mediastinum: a study of 24 cases. Cancer 1975;36:1162–1168.

    Article  PubMed  CAS  Google Scholar 

  3. Dulmet EM, Macchiarini P, Suc B, Verley JM. Germ cell tumors of the mediastinum: a 30-year experience. Cancer 1993;72:1894–1901.

    Article  PubMed  CAS  Google Scholar 

  4. Toner GC, Geller NL, Lin SY, Bosl GJ. Extragonadal and poor risk nonseminomatous germ cell tumors. Cancer 1991;67:2049–2057.

    Article  PubMed  CAS  Google Scholar 

  5. Jacqueline V, Manjit B, Jennifer B, Geralyn H, Dean FB, Madhu M, et al. Role of postchemotherapy adjunctive surgery in the management of patients with nonseminoma arising from the mediastinum. J Clin Oncol 2001;19:682–688.

    Google Scholar 

  6. Vogelzang NJ, Raghavan D, Anderson RW, Rosai J, Levitt SH, Kennedy BJ, et al. Mediastinal nonseminomatous germ cell tumors: the role of combined modality therapy. Ann Thorac Surg 1982;33:333–339.

    Article  PubMed  CAS  Google Scholar 

  7. Asamura H, Tsuchiya R, Goya T, Kondo H, Naruke T, Saijo N, et al. Malignant germ cell tumor of the mediastinum: a multimodality therapeutic approach. Surg Today 1994;24:137–141.

    Article  PubMed  CAS  Google Scholar 

  8. Collins D, Pugh R. Classification and frequency of testicular tumors. Br J Urol 1964;36(suppl 1):11.

    Google Scholar 

  9. Friedman N. The comparative morphogenesis of extragenital and gonadal teratoid tumors. Cancer 1951;4:265.

    Article  PubMed  CAS  Google Scholar 

  10. Takeda S, Miyoshi S, Ohta M, Minami M, Masaoka A, Matsuda H, et al. Primary germ cell tumors in the mediastinum. Cancer 2003;97:367–376.

    Article  PubMed  Google Scholar 

  11. International Germ Cell Cancer Collaborative Group. International germ cell consensus classification: a prognostic factor-based staging system for metastatic germ cell cancers. J Clin Oncol 1997;15:594–603.

    Google Scholar 

  12. Kesler KA, Rieger KM, Ganjoo KN, Sharma M, Fineberg NS, Einhorn LH, et al. Primary nonseminomatous germ cell tumors: the influence of postchemotherapy pathology on long-term survival after surgery. J Thorac Cardiovasc Surg 1999;118:692–701.

    Article  PubMed  CAS  Google Scholar 

  13. Sakurai H, Asamura H, Suzuki K, Watanabe S, Tsuchiya R. Management of primary malignant germ cell tumor of the mediastinum. Jpn J Clin Oncol 2004;34:386–392.

    Article  PubMed  Google Scholar 

  14. Kang CH, Kim YT, Jheon SH, Sung SW, Kim JH. Surgical treatment of malignant mediastinal nonseminomatous germ cell tumor. Ann Thorac Surg 2008;85:379–384.

    Article  PubMed  Google Scholar 

  15. Motzer RJ, Bosl GJ. Chemotherapy for germ cell tumors. Urol Clin North Am 1987;14:389–8.

    PubMed  CAS  Google Scholar 

  16. Motzer RJ, Geller NL, Tan CC, Herr H, Morse M, Fair W, et al. Salvage chemotherapy for patients with germ cell tumors: the Memorial Sloan Kettering Cancer Center experience (1979–1989). Cancer 1991;67:1305–1310.

    Article  PubMed  CAS  Google Scholar 

  17. Kesler KA, Rieger KM, Hammoud ZT, Kruter LE, Perkins SM, Turrentine MW, et al. A 25-year single institution experience with surgery for primary mediastinal nonseminomatous germ cell tumors. Ann Thorac Surg 2008;85:371–378.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, National Hospital Organization, Kinkichuo Chest Medical Center, 1180 Nagasone-cho, Sakai, Osaka, 591-8555, Japan

    Yukio Nakamura, Akihide Matsumura, Hiroshi Katsura, Masahiro Sakaguchi, Norimasa Ito, Naoto Kitahara & Naoko Ose

  2. Department of Pathology, National Hospital Organization, Kinki-chuo Chest Medical Center, Osaka, Japan

    Masanori Kitaichi

Authors
  1. Yukio Nakamura
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  2. Akihide Matsumura
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  3. Hiroshi Katsura
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  4. Masahiro Sakaguchi
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  5. Norimasa Ito
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  6. Naoto Kitahara
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  7. Naoko Ose
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  8. Masanori Kitaichi
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Correspondence to Yukio Nakamura.

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Nakamura, Y., Matsumura, A., Katsura, H. et al. Cisplatin-based chemotherapy followed by surgery for malignant nonseminomatous germ cell tumor of mediastinum: one institution’s experience. Gen Thorac Cardiovasc Surg 57, 363–368 (2009). https://doi.org/10.1007/s11748-008-0375-z

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  • DOI: https://doi.org/10.1007/s11748-008-0375-z

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