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Outcomes of combined modality therapy for patients with stage III or IV mediastinal malignant germ cell tumors

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Abstract

Purpose

The treatment of primary mediastinal germ cell tumors with cisplatin-based chemotherapy followed by surgery is an established practice; however, the prognosis has remained poor. This study reviews the survival outcomes of patients with primary mediastinal germ cell tumors to evaluate the efficacy of our treatment.

Methods

We retrospectively reviewed 11 consecutive patients with primary mediastinal germ cell tumors.

Results

We had treated four patients with seminomas and seven patients with non-seminomas. Ten patients had undergone cisplatin-based chemotherapy. All patients underwent complete resection. Two patients showed a failure of first-line chemotherapy and thus received salvage chemotherapies, including paclitaxel plus ifosfamide followed by high-dose carboplatin plus etoposide (TI-CE) with stem cell transplantation. One of them died of relapse 29 months later; while the other patient remained disease-free for 56 months postoperatively. The postoperative overall 3-year survival rates of the patients with non-seminomas and seminomas were 83 and 100 %, respectively.

Conclusion

Complete resection after establishing normalized or decreased at a low-level serum tumor markers plateau plays a crucial role in the management of patients with primary mediastinal malignant germ cell tumors.

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The authors have no conflict of interest to declare.

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Correspondence to Hideki Kuwano.

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Kuwano, H., Tsuchiya, T., Murayama, T. et al. Outcomes of combined modality therapy for patients with stage III or IV mediastinal malignant germ cell tumors. Surg Today 44, 499–504 (2014). https://doi.org/10.1007/s00595-013-0562-0

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  • DOI: https://doi.org/10.1007/s00595-013-0562-0

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